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Research Paper
Effects of an expressive writing program for women with high-risk first pregnancies: a quasi-experimental study
Jae-Mi Kwon, Hye-Jin Kim
Received March 26, 2026  Accepted September 28, 2026  Published online November 12, 2026  
DOI: https://doi.org/10.4040/jkan.26045    [Epub ahead of print]
AbstractAbstract PDFePub
Purpose
This study aimed to develop an expressive writing program for hospitalized women with high-risk first pregnancies and evaluate its effects.
Methods
A quasi-experimental study with a nonequivalent control group pretest–posttest design was used. Hospitalized women with high-risk first pregnancies in the experimental group (n=24) participated in four expressive writing sessions over four days, whereas those in the control group (n=24) received standard nursing care. From May to November 2024, data on stress, state anxiety, depression, and maternal–fetal attachment were collected using structured questionnaires. Two-way repeated-measures analysis of variance was used to assess the effects of time, group, and their interaction on each outcome. This study was registered with the Clinical Research Information Service (CRIS KCT0010097).
Results
For stress, the main effects of time (F=1.13, p=.327) and group (F=2.38, p=.130) were not significant; the time×group interaction (F=1.43, p=.244) was also not significant. For state anxiety, the main effects of time (F=9.41, p<.001) and group (F=5.03, p=.030) were significant, as was the time×group interaction (F=3.21, p=.045). For depression, the time×group interaction was also significant (F=3.13, p=.049).
Conclusion
This study confirmed the effectiveness of an expressive writing program in reducing state anxiety and depression among women with high-risk pregnancies. The findings may inform the development of nursing interventions to address emotional needs in this population, and future use of the program is anticipated.
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Original Article
Effects of an Integrated Physical Activity Program for Physically Inactive Workers - Based on the PRECEDE-PROCEED Model -
Hye-Jin Kim, Jina Choo
J Korean Acad Nurs 2018;48(6):692-707.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.6.692
AbstractAbstract PDF
Abstract Purpose

We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model.

Methods

Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism.

Results

Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group.

Conclusion

The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

Citations

Citations to this article as recorded by  
  • Factors Associated with Low Handgrip Strength among Community-Dwelling Older Adults based on the PRECEDE Model: A Focus on Resistance Exercise
    Hye Young Choi, Eun Joo Ji
    Journal of Korean Public Health Nursing.2026; 40(2): 210.     CrossRef
  • The Impact of Post-Traumatic Stress Disorder Symptoms on Depressive Symptoms and Health-Promoting Behaviors Among Korean Coast Guards: The Mediating Role of Social Support
    Hyung-Eun Seo, Mijung Yeom, Hye-Jin Kim
    Workplace Health & Safety.2025; 73(5): 236.     CrossRef
  • The characteristics, components, and fidelity of interventions promoting physical activity in people living with musculoskeletal conditions: a systematic review
    Alex Thompson, Robert Copeland, Rachel Young, Angela Reilly, Jeff Breckon, Sionnadh McLean
    Disability and Rehabilitation.2025; 47(23): 6020.     CrossRef
  • Strategies for preventing presenteeism in nursing
    Luís Sousa, Ricardo Mestre, João Tomás, Sandy Severino, Nelson Guerra, Helena José
    Management (Montevideo).2025; 3: 147.     CrossRef
  • Use of the PRECEDE–PROCEED Model to Pilot an Occupational Physical Activity Intervention: Tailored Through a Community Partnership
    Debra L. Fetherman, Joan Cebrick-Grossman
    Workplace Health & Safety.2023; 71(8): 367.     CrossRef
  • Corporate Well-Being Programme in COVID-19 Times. The Mahou San Miguel Case Study
    José M. Núñez-Sánchez, Ramón Gómez-Chacón, Carmen Jambrino-Maldonado, Jerónimo García-Fernández
    Sustainability.2021; 13(11): 6189.     CrossRef
  • Effects of an Integrated Physical Activity Program for Physically Inactive Workers: Based on the PRECEDE-PROCEED Model
    Hye-Jin Kim, Jina Choo
    Journal of Korean Academy of Nursing.2018; 48(6): 692.     CrossRef
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