Journal of Korean Academy of Nursing

Research Papers

Perspectives of parents, teachers, and community leaders on adolescent sexual behavior across ecological contexts in Cambodia: a qualitative study: Youngran Yang, Gloria Park; Received October 31, 2025 Accepted January 24, 2026 Published online February 25, 2026; DOI: https://doi.org/10.4040/jkan.25146 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study investigated the perspectives of parents, teachers, and community leaders regarding adolescents’ sexual behavior in Cambodia.
Methods
Grounded in the ‘ecological framework of adolescent health,’ this study employed a descriptive qualitative approach to explore the perspectives of key stakeholders, including 12 parents, eight teachers, and four community leaders. Drawing on in-depth, semi-structured individual and focus group interviews, the study examined risk and protective factors related to risky sexual behavior across family, school, community, social, cultural, and policy contexts. Data collection was conducted from December 5, 2022 to January 31, 2023.
Results
The integrated thematic analysis revealed six main themes. Parents positioned themselves as anxious protectors but struggled with limited opportunities for open conversation; teachers acted as observe-and-warn mediators, constrained by institutional authority, curricular boundaries, and rapidly shifting youth culture; and community leaders interpreted emerging trends through the lens of social change, eroding traditions, and weakening collective governance. Across groups, participants acknowledged the limitations of unilateral action and advocated for multilevel, collaborative solutions that bridge families, schools, and broader communities.
Conclusion
The study concluded that adolescent sexual behaviors should be understood from diverse perspectives. This finding highlights the need for culturally appropriate and sensitive measures supported by multisectoral systems operating at the family, school, community, civil society (e.g., non-governmental organizations), and national levels.

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Factors influencing smartphone overdependence in university students: an ecological model: a descriptive study: Jeong Soon Yu, Myung Soon Kwon; J Korean Acad Nurs 2025;55(1):64-80. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24092

Abstract PDF ePub: Purpose
This study investigated the factors influencing smartphone overdependence in university students using an ecological model and descriptive research.
Methods
Data were collected from 482 students at 13 universities in the six regions in South Korea from October 20, 2020, to March 25, 2021. Data analysis involved descriptive statistics, the chi-square test, the independent samples t-test, analysis of variance, and hierarchical multiple regression.
Results
The significant ecological factors influencing smartphone overdependence included self-awareness of smartphone overdependence (β=.33, p<.001), autonomy (β=–.25, p<.001), average daily smartphone usage time (β=.18, p<.001), gender (β=.15, p=.001), college year (β=.15, p=.020), forming relationships with others as a motivation for smartphone use (β=–.15, p=.008), friend support (β=.14, p=.006), and age (β=–.12, p=.047). The model explained 34.9% of the variance.
Conclusion
The study emphasized the role of personal and interpersonal factors, in smartphone overdependence among university students. Tailored intervention strategies are necessary to address smartphone overdependence, considering the unique characteristics of students’ environments. A significant aspect of this study is that it provides an explanation of the multidimensional factors contributing to smartphone overdependence among university students, including intrapersonal, interpersonal, and environmental influences.

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Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study: Haengsuk Kim, Wanju Park; J Korean Acad Nurs 2025;55(1):81-92. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24088

Abstract PDF ePub: Purpose
This study investigated the mediating effect of grit in the relationship between silence behavior and medication safety competence among nurses.
Methods
The study included 166 nurses from four university hospitals and general hospitals in Seoul and Gyeonggi-do, South Korea. Data were collected from March 1 to 10, 2024, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffé’s test, and Pearson’s correlation coefficients with IBM SPSS Statistics ver. 23.0 (IBM Corp.). A mediation analysis was performed using Hayes’s PROCESS macro model 4 and the bootstrapping method.
Results
Medication safety competence showed significant correlations with silence behavior (r=–.21, p=.008) and grit (r=.43, p<.001). Furthermore, grit partially mediated the relationship between silence behavior and medication safety competence.
Conclusion
This study indicates that grit is a significant mediator in the relationship between silence behavior and medication safety competence. Therefore, an integrated approach that reduces silence behavior and promotes grit is essential for strengthening nurses’ medication safety competence. Ultimately, these strategies will help ensure patient safety by improving medication safety competence.

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Examination of Predicting Factors for COVID-19 Vaccination Behaviors of University Students Utilizing the Theory of Planned Behavior: Yeon Jeong Heo, Hye-Jin Hyun; J Korean Acad Nurs 2024;54(2):178-192. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.24020

Abstract PDF: Purpose
This study aimed to examine the predictive factors of COVID-19 vaccination behavior by evaluating the moderating effect of perceived behavioral control on the theory of planned behavior.
Methods
Data were collected from August 6 to August 31, 2022 from 235 college students (aged 20~29 years) across 12 universities using a structured web-based survey. Statistical analyses were conducted using the SPSS and AMOS software.
Results
Attitudes toward COVID-19 vaccination, subjective norms, and intention to be vaccinated significantly influenced COVID-19 vaccination behavior. Attitudes and subjective norms indirectly affected COVID-19 vaccination behavior through intention to vaccinate, whereas intention to vaccinate had a direct effect. The moderating effect of perceived behavioral control on the relationship between subjective norms and intention to vaccinate was significant.
Conclusion
Interventions that foster a positive attitude toward COVID-19 vaccination and bolster subjective norms and perceived behavioral control can boost the intention to be vaccinated and facilitate the uptake of COVID-19 vaccination.

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Development of the Hospital Nurses’ Silence Behavior Scale: Soojin Chung, Jee-In Hwang; J Korean Acad Nurs 2024;54(2):279-295. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23138

Abstract PDF

Purpose
This study aimed to develop a scale to measure hospital nurses’ silence behavior and examine its validity and reliability.
Methods
A total of 52 preliminary items on hospital nurses’ silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson’s correlation coefficient was used for assessing concurrent validity, and Cronbach’s alpha was used for the reliability test.
Results
The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the ‘Organizational Silence Scale (OSS)-the issues on which nurses remain silent’ (r = .60, p < .001) and ‘OSS-the reasons why nurses remain silent’ (r = .68, p < .001). Cronbach’s α of the scale was .92, and α of each subscale ranged from .71 to .90.
Conclusion
The Hospital Nurses’ Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.

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Mediating Effect of Emotional Labour on the Role Pressure and Silence Behaviour of Nurses
Lianci He, Jianhua Liu, Rong Sun, Yuan Deng, Ling Tang, Shaochuan Chen
Evaluation & the Health Professions.2026; 49(1): 3. CrossRef
Mediating effect of grit on the influence of nurses’ silence behavior on medication safety competence: a cross-sectional study
Haengsuk Kim, Wanju Park
Journal of Korean Academy of Nursing.2025; 55(1): 81. CrossRef
Influence of Clinical Nurses’ Organizational Silence on Organizational Citizenship Behavior: Mediating Effect of Organizational Commitment Moderated by Organizational Justice
Shin Ae Hwang, Haeyoung Min
Journal of Korean Academy of Nursing Administration.2024; 30(4): 416. CrossRef
Psychometric evaluation and translation of the Persian version of the Organizational Silence Behavior Scale (OSBS-P) for clinical nurses
Alireza Mirzaei, Mobina Jamshidinia, Mehrzad Aghabarari, Pouya Dolat Abadi, Reza Nemati-Vakilabad, Ehsan Namaziandost
PLOS ONE.2024; 19(12): e0314155. CrossRef

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Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis: Hyesun Jeong, Yesul Lee, Jin Sup Park, Yoonju Lee; J Korean Acad Nurs 2024;54(2):162-177. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23136

Abstract PDF

Purpose
This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel’s uncertainty in illness theory (UIT).
Methods
We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data.
Results
The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior.
Conclusion
The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.

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Health uncertainty: Scale development and its effect on health behaviors
Rui Ren, Su Tao, Yuhua Ouyang, Wenchong Du
Journal of Health Psychology.2026;[Epub] CrossRef
Self-Care, Resilience, and Uncertainty in Patients After Coronary Artery Bypass Graft Surgery
Eun-Hye Park, JiYeon Choi, Phill Ja Kim, Jiyeon Lee
Journal of Cardiovascular Nursing.2025;[Epub] CrossRef
Association between Coping Profiles and Cardiac Health Behavior among Patients with Coronary Artery Disease: A Latent Profile Analysis
Yesul Lee, Yoonju Lee, Jeong Cheon Choe, Hyesun Jeong, Sunyoung Jung
Korean Journal of Adult Nursing.2024; 36(3): 228. CrossRef

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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial: Eun Jin Kim, Seon Young Hwang; J Korean Acad Nurs 2024;54(1):44-58. Published online February 29, 2024; DOI: https://doi.org/10.4040/jkan.23090

Abstract PDF

Purpose
This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness.
Methods
Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0.
Results
The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol.
Conclusion
Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.

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Adherence to a Heart-Healthy Lifestyle
Yura Shin, Jina Choo, Songwhi Noh
Journal of Cardiovascular Nursing.2025;[Epub] CrossRef

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Development of Nursing Clinical Judgment Scale: Shi Nae Kwon, Hyojung Park; J Korean Acad Nurs 2023;53(6):652-665. Published online December 31, 2023; DOI: https://doi.org/10.4040/jkan.23042

Abstract PDF

Purpose
This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses.
Methods
A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale.
Results
The final scale comprised 23 items scored on a 5-point Likert scale. Six factors – integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues – accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach’s α for all the items was .92.
Conclusion
The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

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How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Mi Hwa Seo, Eun A. Kim, Hae Ran Kim, Mohammad Jamil Rababa
PLOS ONE.2025; 20(1): e0316654. CrossRef
Effects of Critical Thinking Disposition, Clinical Judgement, and Nurse–Physician Collaboration on Triage Competency Among Triage Nurses
Ji-Won Song, Hyung-Ran Park
Healthcare.2025; 13(4): 405. CrossRef
Effectiveness of a virtual reality nursing simulation for pediatric pneumonia care: a Korean pilot study using a single-group pre-post test design
Eun Joo Kim, Seong Kwang Kim, Sung Sook Song
Child Health Nursing Research.2025; 31(4): 198. CrossRef
The Influence of Clinical Nurses' Clinical Judgment, Nursing Work Environment and Ethical Nursing Competence on Patient Safety Nursing Activities
Eunseo Hong, Hyojung Park
Journal of Korean Public Health Nursing.2025; 39(3): 368. CrossRef

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Adolescents’ Experiences of Non-Suicidal Self-Injury: An Interpretative Phenomenological Analysis Study: Jung A Ko, Ji Young Kim; J Korean Acad Nurs 2023;53(5):538-555. Published online October 31, 2023; DOI: https://doi.org/10.4040/jkan.23075

Abstract 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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Collaborative Immersive Virtual Environments in Geography Education on Climate Zones: A UX Case Study
Martina Střechová, Michal Černý, Čeněk Šašinka, Zdeněk Stachoň, Alžběta Šašinková, František Holubec, Hana Švédová
ISPRS International Journal of Geo-Information.2025; 14(12): 455. CrossRef
Experiences of Male Nursing Students in Women's Health Nursing Practicum: A Mixed-Methods Study Using Photovoice
Na Won An, Na Kyoung Lee
Journal of Korean Association for Qualitative Research.2024; 9(2): 104. CrossRef

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Exploring Spatial Variations and Factors associated with Walking Practice in Korea: An Empirical Study based on Geographically Weighted Regression: Eunjoo Kim, Yeongseo Lee, Ju Young Yoon; J Korean Acad Nurs 2023;53(4):426-438. Published online August 31, 2023; DOI: https://doi.org/10.4040/jkan.23045

Abstract PDF: Purpose
Walking practice is a representative indicator of the level of physical activity of local residents. Although the world health organization addressed reduction in prevalence of insufficient physical activity as a global target, the rate of walking practice in Korea has not improved and there are large regional disparities. Therefore, this study aimed to explore the spatial variations of walking practice and its associated factors in Korea.
Methods
A secondary analysis was conducted using Community Health Outcome and Health Determinants Database 1.3 from Korea Centers for Disease Control and Prevention. A total of 229 districts was included in the analysis. We compared the ordinary least squares (OLS) and the geographically weighted regression (GWR) to explore the associated factors of walking practice. MGWR 2.2.1 software was used to explore the spatial distribution of walking practice and modeling the GWR.
Results
Walking practice had spatial variations across the country. The results showed that the GWR model had better accommodation of spatial autocorrelation than the OLS model. The GWR results indicated that different predictors of walking practice across regions of Korea.
Conclusion
The findings of this study may provide insight to nursing researchers, health professionals, and policy makers in planning health programs to promote walking practices in their respective communities.

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Factors Affecting Radiation Protective Behaviors in Perioperative Nurses Applying the Theory of Planned Behavior: Path Analysis: Se Young Jang, Hee Sun Kim, Seok Hee Jeong, Young Man Kim; J Korean Acad Nurs 2023;53(2):222-235. Published online April 30, 2023; DOI: https://doi.org/10.4040/jkan.22099

Abstract PDF

Purpose
The aim of this study was to identify the factors explaining protective behaviors against radiation exposure in perioperative nurses based on the theory of planned behavior.
Methods
This was a cross-sectional study. A total of 229 perioperative nurses participated between October 3 and October 20, 2021. Data were analyzed using SPSS/WIN 23.0 and AMOS 23.0 software. The three exogenous variables (attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control) and two endogenous variables (radiation protective intention and radiation protective behaviors) were surveyed.
Results
The hypothetical model fit the data (χ2/df = 1.18, SRMR = .02, TLI = .98, CFI = .99, RMSEA = .03). Radiation protective intention (β = .24, p = .001) and attitude toward radiation protective behaviors (β = .32, p = .002) had direct effects on radiation protective behaviors. Subjective norm (β = .43, p = .002) and perceived behavior control (β = .24, p = .003) had direct effects on radiation protective intention, which explained 38.0% of the variance. Subjective norm (β = .10, p = .001) and perceived behavior control (β = .06, p = .002) had indirect effects via radiation protective intention on radiation protective behaviors. Attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control were the significant factors explaining 49.0% of the variance in radiation protective behaviors.
Conclusion
This study shows that the theory of planned behavior can be used to effectively predict radiation protective behaviors in perioperative nurses. Radiation safety guidelines or education programs to enhance perioperative nurses’ protective behaviors should focus on radiation protective intention, attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control.

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Health Protective Behavior in Occupational Health Practice: A Concept Analysis
Fenggang Liu, Juanjuan Wang, Weeraporn Suthakorn, Li Liao
Health Science Reports.2025;[Epub] CrossRef
Factors related to preventive measures towards PM2.5 exposure: A systematic review
Jeevan Bhatta, Orapin Laosee, Cheerawit Rattanapan
Global Transitions.2024; 6: 212. CrossRef
Factors Influencing Radiation Protection Behavior of Nurses in Intensive Care Units
Seo Jeong Kim, Yun Hee Kim
Journal of Korean Critical Care Nursing.2024; 17(3): 1. CrossRef
A Review of the Relationship between Health Behaviors and Career Adaptability among University Students
Dongming Jia, Xia Yuan
Journal of Medicine and Health Science.2024; 2(4): 43. CrossRef

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Moderating the Effects of Health Behaviors on Sexual Intercourse among Adolescents: A CrossSectional Study Using the 2020 Adolescent Health Behavior Survey: Eunmi Lee, Youngran Yang; J Korean Acad Nurs 2022;52(5):499-510. Published online October 31, 2022; DOI: https://doi.org/10.4040/jkan.22080

Abstract PDF

Purpose
This study investigated the association between adolescent health behaviors (drinking, smoking, and drug use) and sexual intercourse, as well as the moderating effects of economic status, cohabitation with parents, and school type, among adolescents in Korea.
Methods
Secondary data from the 16th Adolescent Health Behavior Survey (2020) were used. A total of 395 schools and 54,948 middle and high school students participated in the study. Complex sample frequency analysis, the Rao–Scott test, and complex sample logistic regression analyses were performed.
Results
Sexual intercourse rates for men and women were 5.8% and 3.3%, respectively. Approximately 7.3% of high school students and 1.8% of middle school students reported having had sexual relations. Drinking (odds ratio [OR] = 3.15, 95% confidence interval [CI] = 2.82~3.52), smoking (OR = 6.75, 95% CI = 5.90~7.71), and drug use (OR = 3.03, 95% CI = 2.23~4.11) significantly increased the risk of sexual intercourse. Economic status and school type had moderating effects on the association between drinking and sexual intercourse.
Conclusion
Adolescent drinking, smoking, and drug use are associated with a higher risk of sexual experience. Thus, to reduce this risk, controlling alcohol consumption, smoking, and drug use is necessary. In addition, programs for healthy lifestyles and sexual intercourse should be differentiated according to the school type and the economic conditions of the adolescents’ households.

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Public discourse on substance use behavior as a driver of public policy: a scoping review of South Korean academic and official literature
Meekang Sung, Jihye Han, Carrie G. Wade, Vaughan W. Rees
Addiction Research & Theory.2025; 33(4): 312. CrossRef

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The Influence of Parental Self-Esteem on Late School-Aged Children’s Media Device Addiction: The Mediating Effect of Marital Conflict and Children’s Self-Esteem: Dayeon Heo, Suk-Sun Kim; J Korean Acad Nurs 2022;52(4):421-434. Published online August 31, 2022; DOI: https://doi.org/10.4040/jkan.22036

Abstract PDF

Purpose
This study aimed to examine the effect of parental self-esteem on late school-aged children’s media device addiction by mediating marital conflict and children’s self-esteem.
Methods
This study used data from the 11th (2018) Panel Study on Korean Children. The participants consisted of 1,082 family triads (fathers, mothers, and children). Data were collected using the Rosenberg Self-Esteem Scale, Marital Conflict Scale, and K-Internet Addiction Scale. The data were analyzed using structural equation modeling with SPSS/WIN 27.0 and Mplus 8.7.
Results
The final model showed a good fit for the data. Children’s media device addiction was directly related to mothers’ self-esteem, mothers’ marital conflict, and children’s self-esteem. Fathers’ self-esteem had a significant indirect effect on children’s media device addiction by mediating both fathers’ and mothers’ marital conflict. In addition, mothers’ self-esteem had a significant indirect effect on children’s media device addiction by mediating mothers’ marital conflict.
Conclusion
The findings indicates that self-esteem and marital conflict for both fathers and mothers have a significant effect on children’s media device addiction. It suggests that more attention might be given to fathers and mothers in developing interventions to prevent children’s media device addiction.

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A longitudinal study of the relationship between parents’ self-esteem and children’s digital media addiction: Testing the mediating roles of children’s self-esteem and aggression
Il Bong Mun, Seyoung Lee
The Social Science Journal.2025; 62(3): 802. CrossRef

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Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome: Yun Bock Kwak, Ji Young Kim; J Korean Acad Nurs 2022;52(3):261-277. Published online June 30, 2022; DOI: https://doi.org/10.4040/jkan.21222

Abstract PDF

Purpose
This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support.
Methods
A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann—Whitney U test, ANCOVA, and Ranked ANCOVA.
Results
The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, η_p2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group.
Conclusion
The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.

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User evaluation of a mobile education application for the management of metabolic syndrome among cancer survivors
Ji-Su Kim, Minhae Kim, Yeji Seo
European Journal of Oncology Nursing.2023; 63: 102276. CrossRef
Development and Evaluation of a Web-Based Self-Management Program for Korean Adult Patients with Irritable Bowel Syndrome Based on the Information–Motivation–Behavioral Skills Model
Seohyeon Hwang, Woori Na, Dayoung Oh, Cheongmin Sohn
Applied Sciences.2023; 13(12): 6915. CrossRef
Effect of Patient Safety Training Program of Nurses in Operating Room
Peijia Zhang, Xin Liao, Jie Luo
Journal of Korean Academy of Nursing.2022; 52(4): 378. CrossRef

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

Abstract PDF

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.

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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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A Prediction Model of Exercise Level in Patients with Ankylosing Spondylitis: Moon Ja Kim, Eun Nam Lee; 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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Validity and Reliability of the Korean Version of the Climate, Health, and Nursing Tool: Da Woon Jeong, Gwang Suk Kim, Min Kyung Park; 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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Min Kyung Park, Seoyoung Baek, Da Woon Jeong, Gwang Suk Kim
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Exploring influences of environmental information, beliefs and self‐efficacy on nurses' climate health behaviours and their relationships
Jeongmin Yi, Yeojin Yi
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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
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Pui Hing Chau, Tiffany L.T. Yu, Yan Hu, Yasna K. Palmeiro Silva, Eileen Gilder, Michelle Cole, Roinah Ngunyulu, Chia-Chin Lin
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Özden Buse Yalçin, Betül Aktaş
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Hansol Lee, Jaehee Kim, Yuri Lee
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Yoomi Jung
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Effects of Second Victim Experiences after Patient Safety Incidents on Nursing Practice Changes in Korean Clinical Nurses: The Mediating Effects of Coping Behaviors: Seohee Jeong, Seok Hee Jeong; J Korean Acad Nurs 2021;51(4):489-504. Published online August 31, 2021; DOI: https://doi.org/10.4040/jkan.21089

Abstract PDF

Purpose
This study was investigated the mediating effect of coping behaviors in the relationship between the second victim experiences after patient safety incidents and the nursing practice changes.
Methods
A cross-sectional survey was performed using structured questionnaires. Participants were 218 clinical nurses in general tertiary hospitals in South Korea. Data were collected through an online survey and snowball sampling from August 11 to September 6 2020. Data were analyzed using SPSS 23.0 program. A mediation analysis was performed using multiple regression and a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval.
Results
The mean scores of second victim experiences was 3.41/5. Approach coping (β = .55, p < .001) and the avoidant coping (β = - .23, p = .001) showed mediation effects in the relationship between second victim experiences and constructive change in nursing practice. Avoidant coping (β = .29, p < .001) showed a mediation effect in the relationship between second victim experiences and defensive change in nursing practice.
Conclusion
Coping behaviors has a mediating effect on the relationship between second victim experiences and nursing practice changes. To ensure that nurses do not experience second victim, medical institutions should have a culture of patient safety that employs a systematic approach rather than blame individuals. They also need to develop strategies that enhance approach coping and reducing avoidant coping to induce nurses’ constructive practice changes in clinical nurses in experiencing second victims due to patient safety incidents.

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Factors influencing negative outcomes for nurses who experience patient safety incidents: An integrative review
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Changes in Nursing Practice Among Clinical Nurses After Experiencing a Patient Safety Incident: Partial Least Squares Structural Equation Modeling
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Ahlim Chang, Youngjin Lee, Minkyung Kang, Ji Yea Lee
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“Learn from Errors”: Post-traumatic growth among second victims
Huanhuan Huang, Tong Liu, Ying Peng, Xingyao Du, Qi Huang, Qinghua Zhao, Mingzhao Xiao, Yetao Luo, Shuangjiang Zheng
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Marie M. Prothero, Madeline Sorhus, Katherine Huefner
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Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations
Maria Kappes, Pilar Delgado‐Hito, Verónica Riquelme Contreras, Marta Romero‐García
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The mediating role of coping styles in the relationship between second victim experience and professional quality of life among nurses: a cross-sectional study
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Eun Ha Kim, Yeojin Yi
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Su Jin Jung, Youngjin Lee, Sun Hyoung Bae
Journal of Korean Academy of Nursing Administration.2022; 28(4): 331. CrossRef
Profiles of second victim symptoms and desired support strategies among Korean nurses: A latent profile analysis
Eun Young Choi, Jeehee Pyo, Minsu Ock, Haeyoung Lee
Journal of Advanced Nursing.2022; 78(9): 2872. CrossRef

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Effects of a Cognitive Behavior Therapy Program for Patients with Fibromyalgia Syndrome: A Randomized Controlled Trial: Kyoung Ran Kong, Eun Nam Lee; J Korean Acad Nurs 2021;51(3):347-362. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.21025

Abstract PDF

Purpose
This study developed a cognitive behavioral therapy program aimed at altering the physical condition, emotions, and behaviors of fibromyalgia patients, and confirmed the program’s clinical applicability. The program was developed by analyzing previous studies conducting in-depth interviews with fibromyalgia patients, drawing on cognitive behavior theory to establish the program contents, recruiting experts to test its validity, and conducting a preliminary survey.
Methods
To confirm the program’s effect, this study used a randomized controlled trial design. The participants were outpatients diagnosed with fibromyalgia in Dong-A University Hospital, Busan. The 30 patients in the experimental group took part in the program, which comprised 8 sessions (90 to 120 minutes) based on cognitive behavior theory, delivered over 8 weeks. Hypothesis testing was carried out using the repeated measures ANOVA.
Results
The analysis revealed significant differences between the experimental and control groups in positive automatic thoughts, pain, fatigue, depression, and interpersonal relationships. However, there was no significant difference between the groups in terms of sleep disorders and negative automatic thoughts.
Conclusion
This program is a positive effect on physical condition, emotions, and behaviors. It is thus expected to be used to help fibromyalgia patients improve their disease conditions.

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An-Na Yeo, Yu-Min Kang, Su-Young Lee
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Influences of Autonomic Function, Salivary Cortisol and Physical Activity on Cognitive Functions in Institutionalized Older Adults with Mild Cognitive Impairment: Based on Neurovisceral Integration Model: Minhee Suh; J Korean Acad Nurs 2021;51(3):294-304. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.20282

Abstract PDF

Purpose
This study aimed to investigate objectively measured physical activity (PA) in institutionalized older adults with mild cognitive impairment (MCI) and to elucidate the influence of autonomic nervous function, salivary cortisol, and PA on cognitive functions based on neurovisceral integration model.
Methods
Overall cognitive function was evaluated using the mini-mental state examination (MMSE) and executive function was evaluated using semantic verbal fluency test and clock drawing test. Actigraph for PA, HRV and sAA for autonomous function, and the geriatric depression scale for depression were used. Saliva specimens were collected in the morning for sAA and cortisol.
Results
Ninety-eight older adults from four regional geriatric hospitals participated in the study. They took 4,499 steps per day on average. They spent 753.93 minutes and 23.12 minutes on average in sedentary and moderate-to-vigorous activity, respectively. In the multiple regression analysis, lower salivary cortisol level (β = - .33, p = .041) and greater step counts (β = .37, p = .029) significantly improved MMSE score. Greater step count (β = .27, p = .016) also exerted a significant influence on verbal fluency, and greater sAA (β = .35, p = .026) was significantly associated with a better clock drawing test result.
Conclusion
Salivary cortisol, sAA and physical activity were significantly associated with cognitive functions. To prevent older adults from developing dementia, strategies are needed to increase their overall PA amount by decreasing sedentary time and to decrease salivary cortisol for cognitive function, and to maintain their sympathetic nervous activity for executive function.

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Association between physical activity levels, sedentary time, and mild cognitive impairment in older adults
Wei Chen, Lei Zhang, Palida Abulizi, Ting Zou, Xuan Xiang, Ruikai Wu, Xiaohui Zhou
Frontiers in Public Health.2026;[Epub] CrossRef
Rest-activity circadian rhythm in hospitalized older adults with mild cognitive impairment in Korea and its relationship with salivary alpha amylase: an exploratory study
Minhee Suh, Jihye Choi
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Circadian Rhythm Changes in Healthy Aging and Mild Cognitive Impairment
Ahmadreza Keihani, Ahmad Mayeli, Fabio Ferrarelli
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Frontiers in Physiology.2023;[Epub] CrossRef

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Effectiveness of Drinking Reduction Program Focused on Self-Determination Enhancement for College Students with Problematic Drinking: Jin-Kyoung Ma, Moon-Sook Yoo; J Korean Acad Nurs 2021;51(3):265-279. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.20247

Abstract PDF

Purpose
This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits.
Methods
This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week. It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0.
Results
The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

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Effects of an intervention based on self-determination theory on self-health management capabilities of middle-aged women in rural areas through the concept of leisure cafeteria
Yang Jun Park, Heui Sug Jo, Hyang Hee Hwang, Yukyung Park
Korean Journal of Health Education and Promotion.2022; 39(1): 59. CrossRef
Development and Effects of a Self-Determination Improvement Program for Preventing Non-Suicidal Self-Injury in Adolescents: A Pilot Study
Jae Woon Lee, In Sook Kim, Ji Won Kim
Journal of Korean Academy of Fundamentals of Nursing.2022; 29(4): 506. CrossRef

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Information Resource Network Analysis of Factors Influencing Breastfeeding Planning and Duration: Eunyoung Lee, Insook Cho, Seong Jin Cho, Eunju Lee; J Korean Acad Nurs 2021;51(2):232-244. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20280

Abstract PDF

Purpose
This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources.
Methods
A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration.
Results
The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital. The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group.
Conclusion
Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.

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Tae Hyeong Kim, Sung-Hoon Chung, Jun Hwan Kim, Youngmin Ahn, Son Moon Shin, Woo Ryoung Lee, Eui Kyung Choi, Juyoung Lee, Hye-Jung Shin, Euiseok Jung, Ju Sun Heo, Jin A Lee, Soon Min Lee, Seong Phil Bae, Jeonglyn Song, Chae-Young Kim, Dae Yong Yi
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A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea
Yong-Sung Choi, Sung-Hoon Chung, Eun Sun Kim, Eun Hee Lee, Euiseok Jung, So Yeon Lee, Wooryoung Lee, Hye Sun Yoon, Yong Joo Kim, Ji Kyoung Park, Son Moon Shin, Ellen Ai-Rhan Kim
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Breastfeeding Success Experience of Primiparas
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Face Mask Usage, Knowledge and Behavior of Face Mask Usage in Older Adults Living Alone in the COVID-19 Era: A-Reum Han, Yeon-Hwan Park; J Korean Acad Nurs 2021;51(2):203-216. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20252

Abstract PDF

Purpose
This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic.
Methods
This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho’s Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach’s α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson’s correlation coefficient, and multiple linear regression.
Results
Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (β = - .31, p < .001), living region (β = .13, p = .017), personal income (β = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (β = .15, p = .010) significantly affected the face mask usage-related behavior.
Conclusion
Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.

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Maliheh Makhtum, Naser Behnampour, Akram Sanagoo, Hossein Nasiri, Leila Jouybari
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Heeyoung Woo, Minkyung Gu
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The association between depression and non‐compliance with COVID‐19 preventive behaviors in South Korean older adults stratified by sex
Jae Jun Lee, Namhee Kim, Min Kyung Park, Hyunju Ji, Gwang Suk Kim
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Factors Associated with Depression in Older Adults Living Alone during the COVID-19 Pandemic
Eun Hye Hong, Kyung Hee Lee
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Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea: Inju Hwang, Kyung-Sook Bang; J Korean Acad Nurs 2021;51(2):188-202. Published online April 30, 2021; DOI: https://doi.org/10.4040/jkan.20217

Abstract PDF

Purpose
This study aimed to develop a program to promote obesity prevention behaviors for pre-schoolers and to confirm the effectiveness of the program in Korea.
Methods
The program comprised 8 sessions for 4 weeks including combined classroom lectures and physical activities. A non-equivalent control group pre-post test study design was used, and seventy two children, aged 5 to 6 years (experimental group: 33, control group: 39) and their parents participated in the study. To examine the effectiveness of the program, children’s knowledge, intake of sugar-added beverages and fruits & vegetables, time of outdoor play and screen time, and parental self-efficacy were measured. Data were analyzed with SPSS/WIN ver. 22.0 and R 4.0.2, using descriptive analysis, chi-square test, Fisher’s exact test, the independent t-test, and Analysis of covariance (ANCOVA).
Results
The results showed that the experimental group reported significantly increased knowledge (p < .001) and longer time of outdoor play on weekends (p = .033). However, there were no significant differences in the intake of sugar-added beverages and fruits & vegetables, screen time, and parental self-efficacy in the two groups.
Conclusion
This study confirms the applicability of an obesity prevention intervention at kindergartens in Korea. The results can be used as basic data for the study of childhood obesity prevention in Korea.

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Sangah Lee, Jiye Kim, Jiyoung Lee, Hyekyeong Kim
Korean Journal of Health Education and Promotion.2022; 39(4): 55. CrossRef
The Let’s Eat Healthy and Move at School program for adolescents in South Korea: Program design, implementation, and evaluation plan using intervention mapping
Jiyoung Park, Gill A. Ten Hoor, Seolhyang Baek, Sochung Chung, Yang-Hyun Kim, Gahui Hwang
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Factors Influencing Health Behavior Compliance in Adult Moyamoya Patients: Bo Eun Kim, Ju-Eun Song; J Korean Acad Nurs 2021;51(1):80-91. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20222

Abstract PDF

Purpose
The purpose of this study was to identify factors influencing health behavior compliance in adult patients with moyamoya.
Methods
A descriptive correlation study was conducted to investigate the factors influencing health behavior compliance. Participants were 142 adult patients diagnosed with moyamoya disease who were hospitalized or visited an outpatient clinic in the Gyeonggi province. Data were collected from December 16, 2019 to April 14, 2020 using self-report questionnaires and analyzed using the IBM SPSS 26.0 Win software.
Results
The hierarchical multiple regression analysis demonstrated that self-efficacy (β = .60, p < .001), social support (β = .13, p = .032), and age (β = .21, p = .005) affected the health behavior of adults with moyamoya disease. These 3 variables explained 62.0% of the variance of health behavior compliance, and the most influential factor was self-efficacy.
Conclusion
Based on the results of this study, it concludes that nursing interventions should be focused on self-efficacy and social support to improve health behavior compliance with adult patients diagnosed with moyamoya disease. For that, various strategies to enhance self-efficacy and social support should be developed and actively applied in the clinical setting for adult moyamoya patients.

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Hae-Na Woo, Yong-Cheol Lim, Joo Hee Lee, Sun Hyoung Bae
Scientific Reports.2024;[Epub] CrossRef

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An Exploratory Study on the Policy for Facilitating of Health Behaviors Related to Particulate Matter: Using Topic and Semantic Network Analysis of Media Text: Hye Min Byun, You Jin Park, Eun Kyoung Yun; J Korean Acad Nurs 2021;51(1):68-79. Published online February 28, 2021; DOI: https://doi.org/10.4040/jkan.20213

Abstract PDF

Purpose
This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies.
Methods
After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6.
Results
In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured.
Conclusion
Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses’ care of vulnerable patients and public health promotion.

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Hansol Choi, Yong Pyo Kim, Yungwook Kim, Ji Yi Lee, Hyemi Lee
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Identifying Trajectories of Behavioral Problems in Children with Allergic Diseases: Secondary Data Analysis of the 5th to 7th Panel Study of Korean Children: Miseon Son, Eunsun Ji; J Korean Acad Nurs 2020;50(6):822-836. Published online December 31, 2020; DOI: https://doi.org/10.4040/jkan.20177

Abstract PDF: Purpose
This study aimed to identify latent classes of behavioral problem trajectories in children with allergic diseases and investigate their predictors.
Methods
This study used data from the 5th to 7th Panel Study of Korean Children. The participants included 840 children aged 4~6 years with allergic diseases. Statistical analyses were conducted using latent class growth analysis and multinomial logistic regression.
Results
The trajectories of both internalizing and externalizing behavioral problems in children with allergic diseases were classified into five groups, that is deteriorative, recovering, changing 1 (decreasing-increasing), changing 2 (increasing-decreasing), and low state persistent group. For the internalizing behavioral problems, predictors were temperament, father’s education, family interaction, and disconnection in peer interaction. For the externalizing behavioral problems, predictors child’s gender, temperament, marital conflict, parenting stress, family interaction, and parenting environment.
Conclusion
Deteriorative group has high-risk behavioral problems in children with allergic diseases. We suggest to provide interventions considering latent problem trajectories based on ecological environments for allergic children.

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Original Articles

Development of a Coping Scale for Infertility-Women (CSI-W): Miok Kim, Jung-Mi Ko; J Korean Acad Nurs 2020;50(5):671-685. Published online October 31, 2020; DOI: https://doi.org/10.4040/jkan.20038

Abstract PDF

Purpose
The purpose of this study was to develop a Coping Scale for Infertility-Women (CSI-W).
Methods
The initial items were based on an extensive literature review and in-depth interviews with seven infertile women. Forty-three items were derived from a pilot survey. Data were collected from 216 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale.
Results
Seven factors containing 28 items (four factors containing 17 items for active coping and three factors containing 11 items for passive coping) were extracted from the exploratory factor analysis to verify the construct validity. The four factors of active coping were confrontation, self-control, seeking social support (spouse), and seeking social support (colleagues and experts). The three factors of passive coping were distancing, escape, and avoidance. These items were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (active coping: Cronbach’s a = .78; passive coping: Cronbach’s a = .81).
Conclusion
As its validity and reliability have been verified through various methods, the CSI-W can contribute to assessing the coping strategies of infertile women.

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Effects of BeHaS Program on Health Behavior, Physiologic Index and Self-Esteem of the Elderly Living Alone with Metabolic Syndrome Based on Community Based Participatory Research: Jong Im Kim, Sun Ae Kim, Keumok Park, Jiyoung Kim, Lina Lee, Si Wan Choi, Bon Jeong Ku; J Korean Acad Nurs 2020;50(4):571-582. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.19261

Abstract PDF

Purpose
This study aimed to determine the effects of a 12-week metabolic syndrome BeHaS (Be Happy and Strong) program in elderly people with metabolic syndrome living alone, based on a community-based participatory research (CBPR).
Methods
A nonequivalent control group pre-posttest design was used, and the participants were 43 elderly people living alone (experimental group 24, control group 19). The experimental group received a one-hour program per week and two individual health consultations during 12 weeks. The control group received two sessions about the metabolic syndrome and two individual health consultations. The effects of health behavior, blood pressure, blood sugar levels, abdominal circumference, triglycerides, and self-esteem were evaluated. The data were analyzed using the independent t-test and Mann-Whitney U test.
Results
The health behavior with respect to the metabolic syndrome in the experimental group increased significantly (t = - 3.19, p = .002). Both diastolic blood pressure and abdominal circumference decreased in the experimental group (t = 2.00, p = .028 and t = 3.91, p < .001). No significant differences were observed between the groups in systolic blood pressure, fasting blood sugar levels, triglycerides, and self-esteem.
Conclusion
The 12-week metabolic syndrome BeHaS program using community resources improves the health of elderly people with metabolic syndrome living alone. Based on these findings, further studies on the effectiveness of the metabolic syndrome BeHaS program and the experiences of those who participated in the CBPR are warranted.

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Factors Influencing Health Behavior Related to Particulate Matter in Older Adults: Min Kyung Park, Gwang Suk Kim; J Korean Acad Nurs 2020;50(3):431-443. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19201

Abstract PDF

Purpose
This study aimed to investigate health behavior related to particulate matter (PM) in older adults and examine the factors affectingit.
Methods
A cross-sectional survey design was used. Data were collected from 150 voluntary older adult participants from Songpa-gu inSeoul. The survey questions measured service perception and experience related to PM, risk perception related to PM, attitude toward riskof PM, and health behavior related to PM.
Results
The average score for health behavior related to PM was 79.37, ranging from 51 to 115.There was a significant positive correlation between health behavior related to PM and risk perception related to PM (r=.58, p <.001) as wellas between health behavior related to PM and attitude toward risk of PM (r=.70, p<.001). Multiple linear regression revealed that healthbehavior related to PM was predicted by levels of the existence of disease related to PM (β=.14, p=.019), service experience related to PM(b=.20, p=.021), risk perception related to PM (b=.20, p=.019), and attitude toward risk of PM (b=.44, p<.001). The model including thesevariables accounted for 47.0% of health behavior related to PM.
Conclusion
Korean older adults have the low level of health behaviorrelated to PM. The findings of this study emphasize that risk perception and attitude toward risk of PM should be evaluated, and theunderlying diseases related to PM and their service experience should be considered in developing intervention to improve health behaviorrelated to PM.

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Review Article

Parental Factors Associated with Smartphone Overuse in Preschoolers: A Systematic Review and Meta-Analysis: Gumhee Lee, Sungjae Kim, Heajin Yu; J Korean Acad Nurs 2020;50(3):349-368. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.19186

Abstract PDF

Purpose
This study aimed to identify parental factors associated with smartphone overuse in preschoolers.
Methods
A systematic reviewwas conducted according to PRISMA guidelines. Relevant studies published in peer-reviewed journals from 2009 to June 2019 were identifiedthrough systematic search in 10 electronic databases (PubMed, CINAHL, Cochrane Central, EMBASE, Web of Science, NDSL, KISS, KMbase,KoreaMed, and RISS). Standardized effect sizes were calculated to quantify the associations of parental factors with smartphoneoveruse in preschoolers using meta-analysis.
Results
A total of 30 cross-sectional studies involving 7,943 participants met the inclusioncriteria. The following were negatively correlated with smartphone overuse in preschoolers: mother’s parenting self-efficacy (r =-.35),mother-child attachment (r =-.28), mother’s positive parenting behavior (r =-.28), mother’s positive parenting attitude (r =-.25), and father’sparenting involvement (r =-.15). Further, maternal factors such as smartphone addiction tendency (r =.41), parenting stress (r =.40), negativeparenting behavior (r =.35), negative parenting attitude (r =.14), smartphone usage time (r =.26), employment status (r =.18), and age(r =.12) were positively correlated with smartphone overuse in preschoolers.
Conclusion
Several parental factors influence smartphoneoveruse in preschoolers. These findings emphasize the need to assess and enhance the parental factors identified in this study to preventsmartphone overuse in preschoolers. Accordingly, we recommend the development of preventive interventions to strengthen parent-relatedprotective factors and mitigate risk factors.

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Original Articles

Development and Effects of Smartphone App-Based Walking Exercise Program for Taxi Drivers: Based on Bandura’s Self Efficacy Theory: Yun Ha Choi, Min-Jeong Chae; J Korean Acad Nurs 2020;50(2):242-254. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.242

Abstract PDF

Purpose
The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes.
Methods
A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks.
Results
Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost- test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program.
Conclusion
The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.

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Development of a Scale for Alcohol Drinking Prevention Behavior in Early Elementary School Based on Ajzen’s Theory of Planned Behavior: Younkyoung Kim, Chong Mi Lee, Seo Young Kang; J Korean Acad Nurs 2020;50(2):210-227. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.210

Abstract PDF

Purpose
This study aimed to develop a scale to measure variables related to alcohol drinking prevention behavior in early elementary school, based on the theory of planned behavior.
Methods
A scale was developed to measure variables related to alcohol drinking prevention behavior. Initial items for direct evaluation were constructed through a literature review, and those for belief-based indirect measure were generated through interviews with 30 second- and third-grade elementary school students. The collected data from 286 third-grade elementary school students were then subjected to item analysis, exploratory and confirmative factor analysis, criterion-related validity testing, and internal consistency assessment.
Results
The final scale consisted of 35 items. Intention, attitudes, subjective norms, and perceived behavioral control explained 82.7% of the variance; behavioral beliefs, normative beliefs, and control beliefs explained 65.6% of the variance; and evaluation of outcome, motivation to comply, and power of control beliefs explained 72.8% of the variance. The confirmatory factor analysis indicated that the theoretical models had a satisfactory goodness of fit. Criterion-related validity was confirmed between the direct evaluation variables and the indirect measure variables (attitudes r=.64, p <.001; subjective norms r=.39, p <.001; perceived behavioral control r=.62, p <.001). Cronbach’s a was .89 for the direct evaluation variables and .93 for the indirect measure variables.
Conclusion
The scale developed in this study is valid and reliable. It could be used to measure and explain variables related to alcohol drinking prevention behavior in early elementary school.

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Development and Effect of a Smartphone Overdependence Prevention Program for University Students Based on Self-Determination Theory: Myung Soon Kwon, Jeong Soon Yu; J Korean Acad Nurs 2020;50(1):116-131. Published online January 31, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.1.116

Abstract PDF

Abstract Purpose:

This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness.

Methods:

A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0.

Results:

This study showed improvement in the basic psychological needs (F=3.90, p=.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p=.035), relatedness (F=2.89, p=.045), and self-regulatory ability (F=3.11, p=.028) improved significantly.

Conclusion

Study findings indicate that the smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.

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The Effect of a Social Skills Program on Violent Behaviors in Children Aged 60~72 Months: Tülay Kuzlu Ayyildiz, Güler Cimete; J Korean Acad Nurs 2019;49(6):771-782. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.771

Abstract PDF

Purpose

To determine the effects of a child and parent program on developing social skills for preventing violent behaviors in children aged 60~72 months through a specially developed pre and posttest, control group, quasi-experimental study.

Methods

A social skills development program based on Gardner's Multiple Intelligence Theory was used. The data were collected using the Social Skills Assessment Scale (SSAS), a Chart to Monitor Verbal and Behavioral Violence in Children, the Parental Attitude Scale and the Parent Interview Form. This quasi-experimental study that included a pretest, posttest, and control group had a sample comprising 67 children and parents, with 36 in the experimental group, and 31 in the control group.

Results

Over a six-month period, while the social skill scores of the children in the experimental and control groups increased, their violent behaviors decreased (p<.050). Increase in social skill scores and decrease in violent behaviors were higher in the experimental than in the control group children (p<.050). The parents in the experimental group stated that they had started to empathize with their children, using “I” language, and applied rules more consistently after the program.

Conclusion

This program was successful in preventing violent behaviors in children through the development of social skills. Hence, it can be effectively implemented through a teacher/nurse collaboration.

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Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors: So Hee Kang, Seon Young Hwang; J Korean Acad Nurs 2019;49(6):748-759. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.748

Abstract PDF

Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial
Eun Jin Kim, Seon Young Hwang
Journal of Korean Academy of Nursing.2024; 54(1): 44. CrossRef
Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial
Kyong Sil Park, Seon Young Hwang
Asian Nursing Research.2024; 18(2): 81. CrossRef
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Yun Kyeong Lee, Mihae Im, Haeryun Cho
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Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby: Meera Park, Kyung Min Park; J Korean Acad Nurs 2019;49(2):137-148. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.137

Abstract PDF

Purpose

This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby.

Methods

The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used.

Results

For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004).

Conclusion

This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.

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Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease: Kyung Ae Kim, Seon Young Hwang; J Korean Acad Nurs 2019;49(2):113-125. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.113

Abstract PDF

Purpose

The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease.

Methods

This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program.

Results

There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio.

Conclusion

Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

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Development and effectiveness of a mobile-based autonomy support program for the prevention of metabolic syndrome in middle-aged women
Miseon Seo, Eun-Young Jun, Hyunjin Oh
Frontiers in Public Health.2024;[Epub] CrossRef
Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial
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Asian Nursing Research.2024; 18(2): 81. CrossRef
Effects of Breathing Exercises Using Virtual Reality and Schroth Breathing Exercises on the Lung Function of Adults in Their 20s
Byung-Kon Kim, Wook-Jin Lee
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Effectiveness of physical activity monitors in adults: systematic review and meta-analysis
Rasmus Tolstrup Larsen, Vibeke Wagner, Christoffer Bruun Korfitsen, Camilla Keller, Carsten Bogh Juhl, Henning Langberg, Jan Christensen
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Trajectories of subjective health status among married postmenopausal women based on the ecological system theory: a longitudinal analysis using a latent growth model
Eun Jin Kim, Ju-Hee Nho
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Bo LIN, Qiu JIN, Chunhua LIU, Wenhui ZHAO, Runyuan JI
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The effect of behaviour change interventions on changes in physical activity and anthropometrics in ambulatory hospital settings: a systematic review and meta-analysis
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Factors related to the Identification of Middle-Aged Women Who are Disadvantaged by Cardio-cerebrovascular Disease
Moon Jung Kang, Jee Seon Yi, Chang Seung Park
Korean Journal of Women Health Nursing.2018; 24(2): 185. CrossRef

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The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors: Gaeun Park, Haejung Lee, Hyun Yul Kim; J Korean Acad Nurs 2019;49(5):550-561. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.550

Abstract PDF

Abstract Purpose

This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS).

Methods

A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA.

Results

At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS.

Conclusion

The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

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Gustavo Adolfo Pimentel-Parra, Nelia Soto-Ruiz, Paula Escalada-Hernández, Leticia San Martín-Rodríguez, Cristina García-Vivar
JNCI: Journal of the National Cancer Institute.2026;[Epub] CrossRef
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The development of a lifestyle modification mobile application, “Health for You” for overweight and obese breast cancer survivors in Korea
Su-Jin Seo, Ju-Hee Nho, Youngsam Park
Korean Journal of Women Health Nursing.2021; 27(3): 243. CrossRef
Peer‐supported lifestyle interventions on body weight, energy intake, and physical activity in adults: A systematic review and meta‐analysis
Siew Lim, Wai Kit Lee, Andy Tan, Mingling Chen, Chau Thien Tay, Surbhi Sood, Stephanie Pirotta, Lisa J. Moran, Meena Daivadanam, Ljoudmila Busija, Helen Skouteris, Mamaru A. Awoke, Briony Hill
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Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults: Su Hyun Kim, Min Ji Kim, Sang Hee Kim, So Yeon Kim, Chae Yeon Park, Jee Yun Bang; J Korean Acad Nurs 2019;49(4):461-471. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.461

Abstract PDF

Abstract Purpose

The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults.

Methods

A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks.

Results

The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group.

Conclusion

The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.

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Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status: SinYoung Hwang, Smi Choi-Kwon; J Korean Acad Nurs 2019;49(3):340-348. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.340

Abstract PDF

Abstract Purpose

This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities.

Methods

This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data.

Results

The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m², respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020).

Conclusion

LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients’ post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

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Nutritional Intake after Liver Transplant: Systematic Review and Meta-Analysis
Lynsey N. Spillman, Angela M. Madden, Holly Richardson, Fumiaki Imamura, Danielle Jones, Marilyn Nash, Hong Kai Lim, Holly N. Hellawell, Kirsten L. Rennie, Linda M. Oude Griep, Michael Allison, Simon J. Griffin
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Development and Validation of the Communication Behavior Scale for Nurses Caring for People with Dementia: Jihye Lee, Moonhee Gang; J Korean Acad Nurs 2019;49(1):1-13. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.1

Abstract PDF

Abstract Purpose

The purpose of this study was to develop and validate the Communication Behavior Scale for nurses caring for people with Dementia (CBS-D).

Methods

Based on communication accommodation theory, the initial items were generated through a literature review and interviews with 20 experts. Content and face validity of the initial items were assessed. Data from 486 nurses caring for people with dementia were analyzed using item analysis, exploratory and confirmatory factor analysis, criterion-related validity, and internal consistency.

Results

The final scale consisted of 18 items and four factors (discourse response management, interpersonal control, emotional expression, and interpretability) that explained 57.6% of the variance. Confirmatory factor analysis indicated that the theoretical model with 18 items satisfied all goodness-of-fit parameters. Criterion-related validity was shown by the Global Interpersonal Communication Competence Scale (r=.506, p<.001). Cronbach's alpha for the total scale was .88.

Conclusion

The CBS-D can be used to measure the communication behavior of nurses caring for people with dementia.

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Structural Equation Modeling of Self-Care Behaviors in Kidney Transplant Patients Based on Self-Determination Theory: Hye Won Jeong, Hyang Sook So; J Korean Acad Nurs 2018;48(6):731-742. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.6.731

Abstract PDF

Abstract Purpose

The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory.

Methods

Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0.

Results

The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients.

Conclusion

It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

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Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea: Gyuyoung Lee, Ok Kyung Ham, Bo Gyeong Lee, Abuan Micah Kim; J Korean Acad Nurs 2018;48(4):475-484. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.475

Abstract PDF

Abstract Purpose

To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior.

Methods

We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI).

Results

Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p<.05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, aca-demic/internet related problems and rule violations were significantly associated with depressive symptoms (p<.05). General life happiness, worry/ anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p<.05).

Conclusion

Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

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BMC Psychiatry.2019;[Epub] CrossRef

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Effects of Group Rational Emotive Behavior Therapy on the Nurses’ Job Stress, Burnout, Job Satisfaction, Organizational Commitment and Turnover Intention: Hye-Lyun Kim, Sook-Hee Yoon; J Korean Acad Nurs 2018;48(4):432-442. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.4.432

Abstract PDF

Abstract Purpose

This study aimed to develop a Group REBT program with group counseling for nurses and test the effect of group counseling on their job stress, burnout, job satisfaction, organizational commitment, and turnover intention.

Methods

A quasi-experimental study with nonequivalent control group design was employed to identify the effect of the Group REBT program on nurses’ job stress, burnout, job satisfaction, organizational commitment, and turnover intention. Data were collected from 47 participants from two hospitals. The data from the experimental (n=23) and control (n=24) groups were analyzed from January 5 to April 3, 2015. The Group REBT program was conducted eight tmes in all, once a week, with each session lasting 180 minutes. The effect of experimental intervention was measured for each group using a series of structured questionnaires at each of the phases: Pre-intervention, post-intervention (immediately after intervention), and post-intervention (four weeks after intervention). Following this, the significance of the changes in the scores was tested.

Results

The scores of the experimental group, which received the Group REBT program, were compared with those of the control group; the hypotheses were supported in terms of job stress (F=8.85, p<.001), burnout (F=5.62, p=.022), job satisfaction (F=2.70, p=.042), organizational commitment (F=2.97, p=.048), and turnover intention (F=4.60, p=.012).

Conclusion

The Group REBT program was shown to be an effective intervention that could reduce nurses’ job stress and burnout and increase job satisfaction and organizational commitment. Therefore, the Group REBT program can be adopted by nursing organizations to strategically decrease nurses’ turnover intention.

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Perception on Parental Coping on Unintentional Injury of Their Early Infants and Toddlers: Q Methodological Approach: Da In Lee, Ho Ran Park, Sun Nam Park, Sungsil Hong; J Korean Acad Nurs 2018;48(3):335-348. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.335

Abstract PDF: Abstract Purpose
The purpose of this study was to identify parental coping strategies in the face of early infant and toddler injury, and to provide basic data for a parental education program and the most desirable directions it should take.
Methods
A Q-methodology to analyze the subjectivity of each item was used. Thirty-four Q-statements were derived from a literature review and interviews. Forty-seven parents were classified into a shape of normal distribution using a 9-point scale. Collected data were analyzed by the pc-QUANL program.
Results
Five types of parental coping in early infant and toddler injury were identified. Type I was “hospital treatment focused”, type II was “Improving the safety of the child's environment”, type III was “expression of negative emotion”, type IV was “taking the lead in problem solving”, and type V was “Interrogating the person in charge of the situation in which the injury occurred”.
Conclusion
The results of this study indicate that different approaches to educational programs can be used for parents in early childhood injury.

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Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities: Hyun Hwa Hong, Mee Ock Gu; J Korean Acad Nurs 2018;48(2):167-181. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.167

Abstract PDF

Abstract Purpose

We developed and tested the effects of a coping skill training program for caregivers in feeding difficulty among older adults with dementia in long-term care facilities.

Methods

A non-equivalent control group pretest-posttest design was used. The subjects comprised 34 caregivers (experimental group: 17, control group: 17) and 40 older adults with dementia (experimental group: 20, control group: 20). The developed program was delivered in 4-hour sessions over 6 weeks (including 2 weeks of lectures and lab practice on feeding difficulty coping skills, and 4 weeks of field practice). Data were collected before, immediately after, and 4 weeks after the program (January 3 to April 6, 2016). The data were analyzed using t-test and repeated measures ANOVA using SPSS/WIN 20.0.

Results

Compared to their counterparts in the control group, caregivers in the experimental group showed a significantly greater improvement in feeding knowledge and feeding behavior, while older adults with dementia showed greater improvements in feeding difficulty and Body Mass Index.

Conclusion

The study findings indicate that this coping skill training program for caregivers in feeding difficulty is an effective intervention for older adults with dementia in long-term care facilities.

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Predictors of Behavioral and Psychological Symptoms of Dementia: Based on the Model of Multi-Dimensional Behavior: Jeong Eun Yang, Gwi-Ryung Son Hong; J Korean Acad Nurs 2018;48(2):143-153. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.2.143

Abstract PDF

Abstract Purpose

The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested.

Methods

The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program.

Results

Mean score for BPSD was 40.16. Depression (β=.42, p<.001), exposure to noise in the evening noise (β=-.20, p=.014), and gender (β=.17, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model.

Conclusion

To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.

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The influence path of caregivers’ positive aspects, expressed emotion and coping style on behavioral and psychological symptoms of dementia
Shuang Zhang, Xiumei Ying, Shuyan Fang, Wenxia Wang, Xiangning Zhu, Yueyang Dong, Meng He, An Chang, Jiao Sun
Geriatric Nursing.2022; 44: 143. CrossRef

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Effects of Parenting Stress and Controlling Parenting Attitudes on Problem Behaviors of Preschool Children: Latent Growth Model Analysis: Jeong Won Han, Hanna Lee; J Korean Acad Nurs 2018;48(1):109-121. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.1.109

Abstract PDF

Abstract Purpose

This study was conducted to examine the longitudinal effects of parenting stress and parental control attitudes on problem behaviors in preschool children, using a latent growth model.

Methods

Participants were 1,724 pairs of parents and 1,724 preschool children who had completed the panel survey on Korean children (5^th~7^th survey panels).

Results

An analysis of the multivariate latent growth model of parenting stress, parental control attitudes, and children's problem behaviors suggested that the parents’ intercepts for parenting stress influenced their intercepts for parental control attitudes (father: b=.21, p<.001; mother: b=.55, p<.001). In addition, the slopes for fathers’ parenting stress was the only aspect that affected the slopes for mothers’ parental control attitudes (b=.77, p<.001). Moreover, both the intercepts and slopes of parenting stress and parental control attitudes significantly affected the children's problem behaviors.

Conclusion

This study is significant as it provides longitudinal evidence of the impact of parenting stress and parental control attitudes on children's problem behaviors. The findings suggest that accurately assessing changes in parenting stress and parental control attitudes and developing intervention programs to reduce them will be effective in reducing problem behaviors in children.

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Effects of Group Counseling Program Based on Goal Attainment Theory for Middle School Students with Emotional and Behavioral Problems: In Ju Jeong, Soo Jin Kim; J Korean Acad Nurs 2017;47(2):199-210. Published online April 28, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.2.199

Abstract PDF

Purpose

The purpose of this study was to examine the effects of a group counseling program based on goal attainment theory on self-esteem, interpersonal relationships, and school adjustment of middle school students with emotional and behavioral problems.

Methods

Forty-four middle school students with emotional and behavioral problems (22 in the experimental group and 22 in the control group) from G city participated in this study. Data were collected from July 30 to September 24, 2015. The experimental group received the 8-session program, scheduled once a week, with each session lasting 45 minutes. Outcome variables included self-esteem, interpersonal relationship, and school adjustment.

Results

There were significant increases for self-esteem (t=3.69, p=.001), interpersonal relationship (t=8.88, p<.001), and school adjustment (t=4.92, p<.001) in the experimental group compared to the control group.

Conclusion

These results indicate that the group counseling program based on goal attainment theory is very effective in increasing self-esteem, interpersonal relationship, and school adjustment for middle school students with emotional and behavioral problems. Therefore, it is recommended that the group counseling program based on goal attainment theory be used as an effective psychiatric nursing intervention for mental health promotion and the prevention of mental illness in adolescents.

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HyunJung Lee, Bom-Mi Park, Heeju Kim, Jihye Kim, HyunJung Kim
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