Journal of Korean Academy of Nursing

Research Papers

A non-face-to-face diabetes self-management program based on self-efficacy theory and health literacy: a non-randomized controlled trial: Jung Hee Lee, Soo Jin Lee; J Korean Acad Nurs 2025;55(2):165-177. Published online May 23, 2025; DOI: https://doi.org/10.4040/jkan.25009

Abstract PDF ePub: Purpose
This study aimed to assess the impact of a non-face-to-face diabetes self-management program based on self-efficacy theory and focusing on health literacy.
Methods
A quasi-experimental, nonequivalent control group pre–post design was used. Participants from a community health promotion center were included if they (1) were 30–70 years of age, (2) had type 2 diabetes with glycated hemoglobin (HbA1c) ≥6.5%, and (3) had internet access via computers or mobile devices. The 8-week program was developed based on self-efficacy theory, and it included virtual education using an online platform, telephone counseling, videos, and social networking site activities considering health literacy. Fasting blood glucose levels, HbA1c levels, diabetes self-efficacy, social support, depression, and self-management behaviors were assessed. Data were analyzed using the independent t-test, paired t-test, and others.
Results
Post-test results showed that the intervention group had significantly lower fasting blood glucose levels and improved diabetes self-efficacy, social support, and self-management behaviors compared with the control group. An analysis of the pre-to-post changes in scores indicated that the intervention group had significantly greater improvements in fasting blood glucose levels, diabetes self-efficacy, and overall diabetes self-management behaviors than those observed in the control group.
Conclusion
Non-face-to-face programs based on self-efficacy theory that consider health literacy can provide effective diabetes management support to patients when in-person diabetes management at community health centers is challenging.

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Development and evaluation of a question-answering chatbot to provide information for patients with coronary artery disease after percutaneous coronary intervention: Geunhee Lee, Yun Hee Shin; J Korean Acad Nurs 2025;55(2):153-164. Published online May 13, 2025; DOI: https://doi.org/10.4040/jkan.24128

Abstract PDF ePub

Purpose
This study aimed to develop a question-answering chatbot that provides accurate and consistent answers to questions that may arise during the recovery process of patients with coronary artery disease after percutaneous coronary intervention, and to evaluate the chatbot.
Methods
The chatbot was developed through the stages of analysis, design, implementation, and evaluation. It was evaluated by five experts, and the user experience was evaluated by 27 patients who underwent percutaneous coronary intervention. Furthermore, chatbot utilization was analyzed based on user experience logs.
Results
The chatbot was constructed as a question-answering database that included three categories: coronary artery disease, percutaneous coronary intervention, and post-intervention management. The question-answering chatbot, referred to as the “Cardiovascular Strong” channel, has been launched and implemented. An expert evaluation of the chatbot revealed no usability issues or necessary modifications. The overall result of the user experience evaluation was 4.26 points. Based on the user experience log, the question-answer accuracy was 84.6%, and medications during post-intervention management were the most frequently searched topic, accounting for 110 cases (20.8%) out of a total of 528.
Conclusion
The chatbot that was developed to provide information via real-time answers to questions after the intervention can be easily accessed in clinical settings with no time or space constraints. It also will contribute to providing accurate disease-related information via the familiar KakaoTalk platform.

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Generative AI at the Bedside: An Integrative Review of Applications and Implications in Clinical Nursing Practice
Adrianna L. Watson, Carmel Bond, Helen Aveyard, Graeme D. Smith, Debra Jackson
Journal of Clinical Nursing.2025;[Epub] CrossRef

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Review Papers

Effectiveness of non-pharmacological interventions to reduce internalized stigma in people with severe mental illness: a systematic review and meta-analysis: Soyoung Kim, Sun Hyoung Bae, Myung-Sun Hyun; J Korean Acad Nurs 2025;55(1):1-18. Published online February 25, 2025; DOI: https://doi.org/10.4040/jkan.24072

Abstract PDF ePub: Purpose
This study systematically reviewed and analyzed the effects of non-pharmacological interventions on internalized stigma among people with severe mental illness.
Methods
A systematic review and meta-analysis were conducted following the Cochrane Intervention Research Systematic Review Manual and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. This study targeted people with severe mental illness as the population, interventions aimed at reducing internalized stigma, comparisons with control groups, and internalized stigma as the outcome. A literature search was performed across multiple databases, including PubMed, EMBASE, the Cochrane Library, CINAHL, PsycArticles, RISS, KMbase, and KoreaMed. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Effect sizes were computed using Hedges’s g, and subgroup analyses were conducted with Comprehensive Meta-Analysis software version 4.0.
Results
Of 2,388 papers, 15 were included in the meta-analysis. The overall effect size (Hedges’s g) of the intervention was –0.60 (95% confidence interval, –1.01 to –0.19), indicating a statistically significant reduction in internalized stigma (Z=–2.88, p=.004). Subgroup analyses revealed that the intervention type (p=.008) and session length (p=.011) were significant moderators influencing the effectiveness of the interventions.
Conclusion
Tailoring interventions by considering variables such as the intervention type and session length could enhance the effectiveness of non-pharmacological interventions for reducing internalized stigma among people with severe mental illness (PROSPERO: CRD42023418561).

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Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis: Sojeong Jo, Haejung Lee, Gaeun Park; J Korean Acad Nurs 2024;54(3):311-328. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24019

Abstract PDF: Purpose
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
Methods
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Results
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Conclusion
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

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Research Paper

Nurses’ Experiences of the COVID-19 Crisis: Jung-Hoon Lee, Yeoungsuk Song; J Korean Acad Nurs 2021;51(6):689-702. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21160

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