Journal of Korean Academy of Nursing

Variables associated with compliance with standard precautions among hospital nurses: a systematic review and meta-analysis: Song Hee Park, Seok Hee Jeong, Chang Seop Lee, Young Man Kim; J Korean Acad Nurs 2026;56(1):1-26. Published online February 27, 2026; DOI: https://doi.org/10.4040/jkan.25114

Abstract PDF: Purpose
This study aimed to conduct a systematic review and meta-analysis to identify variables associated with standard precautions compliance among hospital nurses and to comprehensively examine their effect sizes.
Methods
A systematic review and meta-analysis were reported in accordance with the PRISMA and MOOSE guidelines. Studies published in English or Korean were retrieved from KMbase, KoreaMed, KISS, ScienceON, RISS, Nanet, DBpia, PubMed, Embase, CINAHL, and CENTRAL. Data collection was conducted from July 6 to July 16, 2024. To ensure a comprehensive search, no restrictions were placed on the publication period, and studies published up to June 2024 were included in the literature search. Analyses were performed using R ver. 4.4.1.
Results
Of the 2,321 studies screened, 50 were included in the systematic review and 41 were included in the meta-analysis. Variables were categorized according to the ecological model. Among individual-level factors, variables with medium correlation effect sizes (ESr ≥.30) included self-efficacy (ESr=.41; 95% confidence interval [CI], 0.24 to 0.56), perceived barriers (ESr=−.35; 95% CI, −0.59 to −0.05), cues to action (ESr=.34; 95% CI, 0.07 to 0.57), and perceived benefits (ESr=.30; 95% CI, 0.13 to 0.46). Among organizational factors, organizational culture for infection control (ESr=.47; 95% CI, 0.39 to 0.54) and patient safety culture (ESr=.44; 95% CI, 0.35 to 0.53) demonstrated medium effect sizes. Other statistically significant variables with small effect sizes were also identified. No variables were identified within the interpersonal, community, or public policy domains.
Conclusion
This study identified self-efficacy and organizational culture for infection control as key determinants of compliance with standard precautions. Strengthening these factors may reduce healthcare-associated infections and promote safer nursing care (PROSPERO registration number: CRD42024566518).

152 View
5 Download

Perspectives of parents, teachers, and community leaders on adolescent sexual behavior across ecological contexts in Cambodia: a qualitative study: Youngran Yang, Gloria Park; J Korean Acad Nurs 2026;56(1):108-122. Published online February 25, 2026; DOI: https://doi.org/10.4040/jkan.25146

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.

222 View
3 Download

Development and evaluation of the Trauma-nursing Education and Skill Support program to enhance trauma nursing competencies: a quasi-experimental study: Tae Yeong Yang, Myung Jin Jang, Ki Ung Kim, Min So, Mi Na Choi, Eun Jung Lee, Jin Su Jo, Ji Yun Lee, Kwang Kyun Lim, Kyoung Mi Kim, Hae Jun Baek, Sun Ho Wang, Jin Oh Choi; J Korean Acad Nurs 2026;56(1):67-80. Published online February 24, 2026; DOI: https://doi.org/10.4040/jkan.25134

Abstract PDF ePub: Purpose
This study aimed to develop and evaluate the effectiveness of the Trauma-nursing Education and Skill Support (TESS) program based on the ADDIE model (Analysis, Design, Development, Implementation, Evaluation model). The program was designed to enhance trauma nurses’ clinical competencies, including trauma-related knowledge, self-efficacy, and problem-solving ability, through the integration of theoretical education and simulation-based practice.
Methods
A quasi-experimental study using a non-equivalent control group pretest–posttest design was conducted. Participants included 108 trauma nurses from regional trauma centers, military trauma centers, and emergency care facilities, who were assigned to an experimental group (n=52) or a control group (n=56). The TESS program consisted of a 2-day, 14-hour blended-learning course that included eight lecture sessions and four simulation-based practice stations. Data were collected at baseline, immediately after the intervention, and at 6 months using validated instruments measuring trauma-related knowledge, self-efficacy, and problem-solving ability. Two-way repeated-measures analysis of variance was used for data analysis.
Results
The experimental group demonstrated significant improvements in trauma-related knowledge, self-efficacy, and problem-solving ability compared with baseline (all p<.001). These improvements were sustained at 6 months, although trauma-related knowledge scores showed a slight decline compared with immediate posttest levels. Between-group analyses confirmed significant group-by-time interaction effects for all outcomes: trauma-related knowledge (η2=0.12, p<.001), self-efficacy (η2=0.09, p=.002), and problem-solving ability (η2=0.08, p=.003).
Conclusion
The TESS program effectively enhanced trauma nurses’ trauma-related knowledge, self-efficacy, and problem-solving ability, with effects sustained for up to 6 months. Incorporating blended learning and simulation-based training into standardized trauma nursing education may strengthen clinical competencies and ultimately contribute to improved patient outcomes.

165 View
14 Download

Experiences of work performance among physician assistant nurses during the period of healthcare disruption in South Korea: a qualitative content analysis: Juyoung Ha, Minji Kim; J Korean Acad Nurs 2026;56(1):98-107. Published online February 24, 2026; DOI: https://doi.org/10.4040/jkan.25133

Abstract PDF ePub: Purpose
This study aimed to explore the work experiences of physician assistant (dedicated nurses in Korea) during the medical service gap caused by physician–government conflicts.
Methods
A qualitative design employing individual in-depth interviews was used. Data were collected from July 18 to August 13, 2025. Fifteen nurses who worked as physician assistant 5 during the healthcare service gap participated in the study. Participants were categorized as follows: (1) nurses in the role before the period of healthcare disruption, (2) those who voluntarily applied after the period of healthcare disruption, and (3) those involuntarily assigned during the period of healthcare disruption. Data were analyzed using conventional content analysis.
Results
Three categories with six subcategories were identified: (1) reconstructing inner experience within an expanded role (unprepared responsibility and burden, inner fulfillment discovered through continuity of care); (2) reconfiguring relationships from a boundary position (feeling distant as “the same yet different” nurses, expansion of mutual understanding in a crisis context); and (3) precarious positioning within an unestablished system (uncertain standing after residents’ return, episodic implementation of non-standardized training).
Conclusion
This study showed that physician assistant who filled residents’ gaps in an incomplete system experienced heavier role burdens, blurred job identity, unequal conditions, and unstable affiliation, while some also found renewed meaning and fulfillment through continuity of care and closer collaboration. With structured education, clearly defined scopes of practice after residents’ return, and stable legal and organizational support, these nurses can function as more than temporary substitutes and help sustain continuity and quality of patient care.

141 View
4 Download

Development and psychometric testing of the Perceived Postoperative Care Competency Scale for Nursing Students: a methodological study: Perihan Şimşek, Gül Çakir Özmen, Melek Ertürk Yavuz, Sema Koçan, Dilek Çilingir; J Korean Acad Nurs 2026;56(1):81-97. Published online February 24, 2026; DOI: https://doi.org/10.4040/jkan.25123

Abstract PDF ePub: Purpose
To improve the quality of postoperative care and promote recovery after surgery, it is important that nursing education is competency-based and that competency assessment is an integral part of the educational process. The purpose of this study was to develop a tool to evaluate nursing students’ perceived competence in postoperative care.
Methods
This cross-sectional methodological study followed DeVellis’s scale development steps and was conducted between December 2022 and March 2023. In this study, 892 students were invited and 703 responded. After exclusions, data from 645 students were analyzed to examine the psychometric structure of the scale using exploratory factor analysis (n=327) and confirmatory factor analysis (n=318). Reliability was assessed by calculating Cronbach’s α coefficients and by test–retest measurement (n=46).
Results
The proposed scale was confirmed to consist of five factors and 28 items (χ2/degrees of freedom=2.25, root mean square error of approximation=.06, normed fit index=.90, and goodness-of-fit index=.85). Cronbach’s α was .97 for the total scale. The data demonstrated high test–retest stability (intraclass correlation coefficient=.88). The scale developed and psychometrically tested in this study revealed a five-factor structure: legal responsibilities and ethical principles (seven items), postoperative nursing care (seven items), interpersonal relations and communication (four items), leadership (six items), and education and professional development (four items).
Conclusion
The scale, which demonstrated very good psychometric properties, would be helpful in assessing perceived postoperative nursing competence among nursing students. This may help students graduate with the necessary knowledge and skills required for postoperative care. However, further research involving larger samples and more diverse cultural contexts is needed to enhance the generalizability of the scale.

125 View
1 Download

Usefulness of Charlson comorbidity index-adjusted mortality prediction tools and factors influencing mortality in intensive care unit patients: a retrospective medical record review–based study: Jai Jung Lee, Dong Yeon Kim, Min Ji Lee, Ji Young Kim; J Korean Acad Nurs 2026;56(1):27-38. Published online February 11, 2026; DOI: https://doi.org/10.4040/jkan.25094

Abstract PDF ePub: Purpose
This study aimed to estimate the mortality rate in adult intensive care units (ICUs) using the Charlson comorbidity index (CCI)-adjusted Acute Physiology and Chronic Health Evaluation (APACHE) II and Simplified Acute Physiology Score (SAPS) III models, and to identify factors influencing mortality.
Methods
This retrospective cohort study included adult patients admitted to the ICU at a tertiary hospital between June 1 and August 31, 2022. Among the 1,098 screened patients, those younger than 18 years, those discharged within 48 hours, and those with missing medical records were excluded. In total, 482 patients were analyzed using the chi-square test, independent t-test, and multivariate logistic regression. Model performance was evaluated using the c-statistic and the Hosmer-Lemeshow goodness-of-fit test.
Results
The predictive accuracy of the mortality models was shown by c-statistic values of 0.817 for APACHE II, 0.857 for SAPS III, 0.697 for CCI, and 0.834 for CCI-adjusted APACHE II (0.834). Mechanical ventilation, cardiopulmonary cerebral resuscitation, continuous renal replacement therapy, and the presence of leukemia or lymphoma were significant predictors of mortality in adult ICU patients. Among the evaluated models, SAPS III and CCI-adjusted APACHE II demonstrated the highest predictive power.
Conclusion
The findings indicate that incorporating comorbidity indices such as the CCI with acute physiological parameters improves the accuracy of mortality prediction in ICU patients. Understanding mortality prediction models is essential for nurses to provide individualized, evidence-based, and high-quality care in adult ICUs.

326 View
11 Download

Psychometric testing of the Korean version of the Undergraduate Nursing Student Academic Satisfaction Scale: a methodological study: Da-In Park, Joohee Shim; J Korean Acad Nurs 2026;56(1):51-66. Published online February 9, 2026; DOI: https://doi.org/10.4040/jkan.25125

Abstract PDF ePub: Purpose
This study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of the Korean version of the Undergraduate Nursing Student Academic Satisfaction Scale (K-UNSASS).
Methods
The K-UNSASS was developed using Brislin’s team-based translation–back-translation approach, with semantic and conceptual equivalence examined. Face validity was assessed, and a pilot test was conducted in November 2022. Content validity was evaluated by an expert panel. Formal data collection was conducted from December 2022 to January 2023. Structural validity was examined using exploratory and confirmatory factor analyses. Reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients.
Results
A total of 482 full-time nursing students, most of whom were in the fourth year of their nursing program, were included in the psychometric testing. Construct validity supported a four-factor structure accounting for 65.9% of the total variance. After removal of three items with unsatisfactory factor loadings, a 45-item K-UNSASS was established. Confirmatory factor analysis of the 45-item K-UNSASS demonstrated an acceptable model fit, and both Cronbach’s alpha and McDonald’s omega coefficients were .97.
Conclusion
The K-UNSASS demonstrates acceptable reliability and validity for assessing academic satisfaction among Korean nursing students. As a culturally relevant instrument, it supports educational improvement through targeted strategies and program evaluation.

245 View
5 Download

Transforming nursing education to enhance integrated nursing competency: a Delphi-based methodological study on symptom-based clinical reasoning: Jeung-Im Kim, Soyoung Yu, Jin-Hee Park, Ju-Eun Song, Eunjung Ryu, JuHee Lee, YeoJin Im; J Korean Acad Nurs 2026;56(1):39-50. Published online February 5, 2026; DOI: https://doi.org/10.4040/jkan.25151

Abstract PDF ePub: Purpose
This study aimed to address the shift toward competency-based education and the planned 2028 “Integrated Nursing” National Licensing Examination (NLE), this study aimed to establish structural alignment among NLE domains, the seven integrated nursing competencies (INCs), and curriculum goals, with a particular focus on implementing symptom-based clinical reasoning (SBCR).
Methods
This Delphi-based methodological study included seven content experts for content validity index (CVI) assessment and 24 nursing education experts who participated in a consensus workshop. The item-level CVI and the scale-level CVI/average were calculated to confirm the linkage between INCs and NLE domains. In addition, qualitative analysis of workshop materials and meeting records was conducted to derive 10 integrated learning topics and to develop an SBCR educational model for the key symptom of headache, grounded in Miller’s Clinical Competence Pyramid (levels 2–4).
Results
The analysis confirmed the validity of integrating the INCs within the overall curriculum structure. The resulting framework delineates staged learning objectives and core clinical questions designed to systematically enhance clinical reasoning, promote safe nursing practice, and support professional reflection within a unified curriculum.
Conclusion
This study provides a practical foundation for nursing curriculum redesign by facilitating a transition from fragmented, subject-based instruction to a holistic, patient-centered SBCR model. This approach aligns with the requirements of the integrated NLE and is expected to contribute to meaningful improvements in actual clinical competency.

257 View
15 Download

Lessons from the US Advanced Practice Registered Nurse system: Eun-Ok Im, Dongmi Kim; J Korean Acad Nurs 2025;55(4):492-505. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25120

Abstract PDF ePub: Purpose
This review compares the development of South Korea’s Advanced Practice Registered Nurse (APRN) system the well-established APRN system in the United States and provides recommendations for future improvements to the APRN system in South Korea.
Methods
To compare the APRN systems between the two countries, an integrative literature review was conducted using multiple databases and professional nursing organization documents and reports from both the United States and South Korea.
Results
Issues were identified in five major domains: (1) research evidence, (2) education and training, (3) the scope of practice, (4) financial mechanisms, and (5) public awareness and acceptance.
Conclusion
Recommendations are made in four areas: (1) building evidence to support APRN programs; (2) strengthening APRN education; (3) establishing legal support and reimbursement mechanisms; and (4) improving public awareness and acceptance of APRNs.

1,060 View
154 Download

Development of an end-of-life care competency scale for nurses in long-term care hospitals: a psychometric validation study: Sookyeon Son, Mi-Kyeong Jeon; J Korean Acad Nurs 2025;55(4):598-612. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25113

Abstract PDF ePub: Purpose
This study aimed to develop a scale to measure end-of-life care (EOLC) competency among nurses working in long-term care hospitals and to evaluate its validity and reliability.
Methods
Preliminary items were developed based on attributes and indicators identified through a conceptual analysis of EOLC competency. The initial version of the scale was refined through expert content validity assessment, item revision, and a pilot test. The main survey was conducted among 460 nurses in long-term care hospitals, and 409 valid responses were analyzed after excluding 51 incomplete or invalid cases. Data were analyzed using software-assisted item analysis, exploratory and confirmatory factor analyses, and assessments of convergent, discriminant, and criterion-related validity, as well as reliability testing.
Results
The initial 55 items were reduced to a final set of 30 items across seven dimensions. Model fit indices indicated good construct validity (χ²/degrees of freedom=1.91, standardized root mean square residual=.06, root mean square error of approximation=.07, Tucker-Lewis index=.90, comparative fit index=.91), with a total explained variance of 70.2%. The scale demonstrated strong criterion-related validity (r=.76, p<.001), high internal consistency (Cronbach’s α=.95; McDonald’s ω=.95), acceptable test–retest reliability (r=.56, p<.001), and an intraclass correlation coefficient of .72 (95% confidence interval, .51–.84; p<.001).
Conclusion
The developed scale is a valid and reliable instrument for assessing EOLC competency among nurses in long-term care hospitals. It can be effectively utilized for educational assessment, training evaluation, and the measurement of program effectiveness in end-of-life care.

980 View
122 Download

Variables influencing digital health literacy in older adults: a systematic review and meta-analysis: Jin Hwa Park, Eun Ju Mun; J Korean Acad Nurs 2025;55(4):651-667. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25112

Abstract PDF ePub: Purpose
This study aimed to synthesize existing evidence on digital health literacy (DHL) among older adults and to estimate the associations between related influencing factors through a systematic literature review and meta-analysis.
Methods
A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Literature searches were performed across PubMed, EMBASE, Cochrane Library, CINAHL, RISS, and DBPIA. The search and screening process was conducted from December 24, 2023, to March 31, 2025. Effect sizes (ESr) using correlation coefficient for each variable were calculated, and meta-analyses were performed using Microsoft Excel and R version 4.3.1.
Results
Forty-seven variables were identified, including two demographic, six physical, six behavioral, 23 psychosocial, and 10 cognitive factors. Meta-analysis results showed that physical, behavioral, psychosocial, and cognitive factors had significant effects on DHL. Among these, digital information level (ESr=.62; 95% confidence interval [CI], 0.55 to 0.69) within the cognitive domain and technophobia (ESr=−.55; 95% CI, −0.47 to −0.40) within the psychosocial domain demonstrated the largest ESr.
Conclusion
Among factors influencing DHL, digital information level and technophobia showed the strongest associations. These findings suggest that improving DHL in older adults requires a dual approach targeting both cognitive and psychosocial dimensions—enhancing digital information skills while reducing technophobia—to effectively support digital engagement and health empowerment in this population (PROSPERO registration number: CRD42023487486).

1,388 View
157 Download

Validity and reliability of the Security Neglect Subscale of the Child Neglect Scale in vulnerable Chinese children: a methodological study: Zexi Su; J Korean Acad Nurs 2025;55(4):613-620. Published online November 27, 2025; DOI: https://doi.org/10.4040/jkan.25089

Abstract PDF ePub: Purpose
Security neglect is common among vulnerable children. The Child Neglect Scale (CNS) is widely used to screen children for neglect. However, little is known about the accuracy of the Security Neglect Subscale when administered in isolation. This study aimed to examine the reliability and validity of the Security Neglect Subscale of the CNS among vulnerable children in China.
Methods
Cluster sampling was used, and 242 vulnerable children participated in the study. Data were analyzed using IBM SPSS ver. 28.0 and Amos ver. 28.0, and the test construct validity of the CNS Security Neglect Subscale was analyzed through confirmatory factor analysis. In addition, convergent and discriminant validity, as well as reliability, were evaluated.
Results
The construct validity of the nine-item CNS Security Neglect Subscale was confirmed by a two-factor structure. The modified model fit the data well, as shown by a normed chi-square of 2.48, a comparative fit index of .97, a Tucker-Lewis index of .96, and a root mean square error of approximation of .08. The model had acceptable convergent and discriminant validity for each structure. The Cronbach’s α coefficient was .87 overall, and values for the two factors ranged from .78 to .93.
Conclusion
The findings of this study support the satisfactory psychometric properties of the CNS Security Neglect Subscale, indicating its utility in evaluating security neglect in vulnerable children in China.

535 View
90 Download

A qualitative exploration of acute stroke patients’ experiences with aphasia in Korea: Jiyeon Kang, Hyunyoung Heo; J Korean Acad Nurs 2025;55(4):621-633. Published online November 25, 2025; DOI: https://doi.org/10.4040/jkan.25132

Abstract PDF ePub: Purpose
This study aimed to explore the lived experiences of patients with acute stroke-related aphasia within the Korean healthcare context.
Methods
A qualitative research design using inductive content analysis was employed, following the Consolidated Criteria for Reporting Qualitative Research guidelines. Fourteen adults with acute stroke-related aphasia participated in one-on-one, in-depth interviews conducted between January and May 2025. Participants were recruited through purposive sampling until theoretical saturation was reached. Data were analyzed using an inductive qualitative content analysis approach.
Results
Five main categories emerged: “suddenly trapped in silence” described the abrupt loss of language, including the inability to articulate intended words and understand others; “emotional impact” captured psychological shock and feelings of loss; “communication crisis” encompassed expressive difficulties, exclusion from decision-making, and social withdrawal; “patient-centered interaction” highlighted supportive communication, empathic care, and active engagement by others; and “emerging hope” reflected signs of recovery, self-directed efforts, and anticipation of improvement. These categories converged into the overarching theme, “communication beyond language,” illustrating how patients sought meaningful interaction despite linguistic limitations.
Conclusion
Acute aphasia extends beyond a language disorder to encompass profound emotional and social experiences. Although communication barriers exist, meaningful interaction remains possible through empathetic, person-centered approaches. Healthcare professionals should recognize that patients with aphasia retain cognitive competence despite expressive limitations. These findings underscore the need to integrate emotional sensitivity into clinical care and to develop training programs that enhance person-centered communication skills in stroke rehabilitation settings.

1,249 View
129 Download

Strategies for expanding the role of advanced practice providers in the Korean nursing workforce: a mixed-methods approach: Jeong Hye Kim, Mi-Kyeong Jeon, Suyoung Choi, Mimi Lee, Su Jung Choi; J Korean Acad Nurs 2025;55(4):568-583. Published online November 21, 2025; DOI: https://doi.org/10.4040/jkan.25106

Abstract PDF ePub: Purpose
This study aimed to propose strategies for strengthening the nursing workforce by expanding their roles as advanced practice providers (APPs).
Methods
A mixed-methods approach was employed, consisting of five focus group interviews (FGIs) with 30 healthcare professionals (including 10 physicians) and a two-round Delphi survey with 49 experts. The FGIs explored practical insights from clinical settings, while the Delphi process validated and prioritized strategic recommendations through expert consensus.
Results
Four major themes emerged from the FGI analysis: (1) utilization of diverse APPs to ensure quality care, (2) expanding the scope of practice of APPs, (3) requirements to ensure the quality of APPs, and (4) strategies for sustainable management of the APP workforce. Building on these findings, the Delphi survey identified five strategic domains: “definition and qualifications,” “scope of practice,” “educational programs,” “credentialing and regulation,” and “support systems.” Key areas of consensus included the need for mandatory clinical experience and specialty training, legal clarification of role boundaries, standardized curricula with certification mechanisms, and institution-led support systems such as task-specific job descriptions and recredentialing processes.
Conclusion
To effectively strengthen APP roles, it is essential to build on the existing advanced practice nurse (APN) framework, which already includes structured curricula and national certification. Furthermore, integrative strategies should be developed to incorporate experienced clinical nurses without APN licenses into the APN system.

1,611 View
164 Download

Risk factors for the readmission of patients with diabetic ketoacidosis: a systematic review and meta-analysis: Hyerim Ji, Sun-Kyung Hwang; J Korean Acad Nurs 2025;55(4):634-650. Published online November 21, 2025; DOI: https://doi.org/10.4040/jkan.25072

Abstract PDF ePub: Purpose
This study aimed to identify risk factors associated with the readmission of patients with diabetic ketoacidosis (DKA) through a systematic review and meta-analysis.
Methods
A systematic literature review was conducted in accordance with the PRISMA guidelines. Relevant studies were retrieved from international databases (PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, and Web of Science) and Korean databases (RISS, KoreaMed, KMbase, KISS, and DBpia). Study quality was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random-effects model with the Hartung-Knapp-Sidik-Jonkman adjustment to account for the limited number of studies and heterogeneity.
Results
Fifteen studies were included in the review, and eight were eligible for meta-analysis. From the systematic review, 21 risk factors for DKA readmission were identified and categorized into five domains: demographic, socioeconomic, diabetes-related, comorbidity, and health-behavioral factors. In the meta-analysis, significant risk factors included low income, psychiatric disorders, and discharge against medical advice.
Conclusion
This study demonstrates that DKA readmissions result from the complex interplay of multiple clinical and social factors. By identifying these risk factors and suggesting risk-stratification criteria, the findings may support the development of tailored interventions, such as self-management education, integrated mental health care, structured discharge planning, and coordinated post-discharge follow-up.

1,322 View
193 Download

Development of a machine learning-based prediction model for early hospital readmission after kidney transplantation: a retrospective study: Hye Jin Chong, Ji-hyun Yeom; J Korean Acad Nurs 2025;55(4):528-542. Published online November 21, 2025; DOI: https://doi.org/10.4040/jkan.25030

Abstract PDF ePub: Purpose
This study aimed to develop and validate a machine learning-based prediction model for early hospital readmission (EHR) post-kidney transplantation.
Methods
The study was conducted at the organ transplantation center of a university hospital, utilizing data from 470 kidney transplant recipients. We built and trained four machine learning models and tested them to identify the strongest EHR predictors. Predictive performance was evaluated using confusion matrices and the area under the receiver operating characteristic curve (ROC AUC).
Results
Among the 470 kidney transplant recipients with a mean age of 46.1 ± 12.02 years, 322 (68.5%) were males, and 74 (15.7%) were readmitted within 30 days after kidney transplantation. In total, 241 (51.2%) recipients were found to have experienced EHR after applying the random over-sampling examples method. The random forest model achieved the best performance, with an ROC AUC of .87 (validation set) and .82 (test set). The 15 most important features were steroid pulse therapy (recipient), cerebrovascular accident (recipient), heart failure (recipient), male sex (donor), cardiovascular disease (recipient), weekend discharge (recipient), peritoneal dialysis (recipient) cerebrovascular accident as the cause of brain death (donor), current smoker (recipient), cardiac arrest (donor), previous kidney transplantation (recipient), age (donor), hypertension (donor), male sex (recipient), and dialysis duration (recipient).
Conclusion
Our framework demonstrated strong predictive interpretability. It can support appropriate and effective clinical decision-making by assisting transplant professionals in stratifying recipients based on their risk of EHR. prioritizing post-discharge care and follow-up for high-risk individuals, and allocating targeted interventions such as closer monitoring or education.

1,195 View
164 Download

Ten-year trends in research designs and keywords: a bibliometric comparison of the Journal of Korean Academy of Nursing and leading international nursing journals: Jin-Hee Park, Hyun Kyoung Kim, Gaeun Kim, Sun Hyoung Bae; J Korean Acad Nurs 2025;55(4):557-567. Published online November 19, 2025; DOI: https://doi.org/10.4040/jkan.25119

Abstract PDF ePub: Purpose
This study compared trends in research designs and keywords by analyzing the abstracts of four major nursing journals over the past decade, focusing on the Journal of Korean Academy of Nursing (JKAN) in comparison with the International Journal of Nursing Studies (IJNS), Journal of Advanced Nursing (JAN), and Japan Journal of Nursing Science (JJNS).
Methods
A bibliometric analysis was conducted, encompassing 5,522 abstracts published between 2015 and 2024. Research designs were first classified as “quantitative,” “qualitative,” or “other,” and then further sub-classified based on international evidence-based frameworks. Text preprocessing was also conducted, and term frequency–inverse document frequency was applied to evaluate keyword importance. The 2015–2019 and 2020–2024 periods were compared to examine changes in both research designs and keyword importance.
Results
Compared to IJNS, JAN, and JJNS, JKAN published more instrument development and analytic studies but fewer randomized controlled trials and systematic reviews. Over time, the number of instrument development and mixed-methods studies in JKAN increased, while high-evidence designs remained scarce. Keyword analysis showed JKAN’s emphasis on psychosocial themes such as self-efficacy, quality of life, and depression, whereas the other journals more often highlighted policy- and institution-related topics. Across journals, COVID-19 and patient safety emerged as important themes after 2020.
Conclusion
JKAN demonstrates strengths in methodological diversity within quantitative research and in digital health–related analytics. However, high-evidence study designs and policy-oriented keywords are underrepresented in JKAN. Strategic expansion toward randomized controlled trials, systematic review, global and digital health, and policy-relevant research is recommended to strengthen JKAN’s international competitiveness.

946 View
115 Download

Multidimensional factors influencing the completion of advance directives among community-dwelling older Koreans: Hee-Ju Ji, Soong-Nang Jang; J Korean Acad Nurs 2025;55(4):543-556. Published online November 18, 2025; DOI: https://doi.org/10.4040/jkan.25098

Abstract PDF ePub: Purpose
This study aimed to examine the multidimensional factors associated with the completion of advance directives (ADs) among community-dwelling older Koreans, guided by conceptual frameworks developed in Asian contexts.
Methods
Data from the 2023 National Survey of Older Koreans (sixth wave) were analyzed for 9,951 community-dwelling older Koreans aged 65 years or older. Complex sample cross-tabulation and binary logistic regression analyses were conducted.
Results
In total, 11.1% of community-dwelling older Koreans had completed an AD. Significant factors associated with AD completion were identified across four domains—personal situation: age, educational level, religion, and housing preference in the event of poor health; socio-cultural: presence of children, participation in social activities and satisfaction with social relationships; physical and illness: the number of chronic diseases; and value system: awareness of hospice and palliative services, participation in death preparedness education, and documentation of organ donation.
Conclusion
Among older Koreans, AD completion represents more than a documentation process; it reflects a complex decision-making process shaped by their values and life circumstances, underscoring the need for supportive interventions. As the highest AD completion rates are found among older adults, related policies should be aligned with older adult-centered policy frameworks.

1,560 View
157 Download

Effects of presenteeism on turnover intention in clinical nurses through the serial mediating roles of missed nursing care and job satisfaction: a cross-sectional predictive correlational study: Hyeonseon Cheon, Seok Hee Jeong, Hyun Kyung Kim, Hyoung Eun Chang; J Korean Acad Nurs 2025;55(4):584-597. Published online November 10, 2025; DOI: https://doi.org/10.4040/jkan.25015

Abstract PDF ePub: Purpose
This study aimed to investigate the two-mediator serial mediation effect of missed nursing care and job satisfaction on the relationship between presenteeism and turnover intention in clinical nurses.
Methods
A cross-sectional predictive correlational study was conducted, and the participants were 208 clinical nurses working in advanced general hospitals in South Korea. Data were collected from October 6 to November 7, 2023 using self-reported questionnaires, including general characteristics, presenteeism, missed nursing care, job satisfaction, and turnover intention. Data were analyzed using IBM SPSS/WIN ver. 29.0 and PROCESS macro ver. 4.2.
Results
Missed nursing care and job satisfaction exhibited a double mediating effect on the relationship between presenteeism and clinical nurses’ turnover intention. In addition, missed nursing care showed a mediating effect on the relationship between presenteeism and clinical nurses’ turnover intention. Job satisfaction had a mediating effect on the relationship between presenteeism and clinical nurses’ turnover intention. Presenteeism had a direct effect on missed nursing care, job satisfaction, and turnover intention. Missed nursing care exerted a direct effect on job satisfaction and turnover intention among clinical nurses. Job satisfaction had a direct effect on turnover intention.
Conclusion
To reduce nurses’ turnover intention, it is essential to develop and implement programs focused on preventing presenteeism. Additionally, organizational initiatives should prioritize active support for nurses’ health management, alleviating the shortage of nursing staff, augmenting job satisfaction, and improving the overall working environment.

1,540 View
217 Download

Effects of an integrated healthcare program for postpartum women: a quasi-experimental study: Eun Suk Hwang, Ju-Hee Nho; J Korean Acad Nurs 2025;55(4):506-518. Published online November 7, 2025; DOI: https://doi.org/10.4040/jkan.25076

Abstract PDF ePub: Purpose
This study aimed to develop and evaluate an integrated healthcare program for postpartum mothers based on Cox’s interaction model of client health behavior.
Methods
A non-equivalent control group pretest-posttest design was used. The integrated healthcare program was administered 6 times over 2 weeks to postpartum mothers in the experimental group (n=21), while the control group (n=23) received standard care. Data were collected from June 3 to July 15, 2024, through structured questionnaires measuring postpartum fatigue, depression, marital intimacy, and mother-infant attachment. Analyses were conducted using IBM SPSS ver. 23.0.
Results
The experimental group showed significantly lower postpartum fatigue (Z=–2.00, p=.023), a significantly proportion of improvement in postpartum depression (χ2=10.32, p=.012), and a significant increase in mother-infant attachment (t=1.70, p=.048) compared to the control group. However, there was no significant difference in marital intimacy between groups (Z=–0.46, p=.326).
Conclusion
These results suggest that an integrated health management program including physical health, psychological stability, and relational support can be used as an effective nursing intervention to promote health in postpartum mothers. Therefore, additional research is warranted that expands and applies integrated programs for postpartum mothers in various environments in postpartum care centers and communities.

1,629 View
228 Download

Development of a predictive model for exclusive breastfeeding at 3 months using machine learning : a secondary analysis of a cross-sectional survey: Hyun Kyoung Kim; J Korean Acad Nurs 2025;55(4):519-527. Published online October 28, 2025; DOI: https://doi.org/10.4040/jkan.25086

Abstract PDF ePub: Purpose
This study aimed to develop a machine learning model to predict exclusive breastfeeding during the first 3 months after birth and to explore factors affecting breastfeeding outcomes.
Methods
Data from 2,579 participants in the Korean Early Childhood Education & Care Panel between March 1 and June 3, 2025 were analyzed using Python version 3.12.8 and Colab. The dataset was split into training and testing sets at an 80:20 ratio, and five classifiers (random forest, logistic regression, decision tree, AdaBoost, and XGBoost) were trained and evaluated using multiple performance metrics and feature importance analysis.
Results
The confusion matrix of the random forest classifier model demonstrated strong performance, with a precision of 86.6%, accuracy of 84.8%, recall of 96.8%, F1-score of 91.9%, and an area under the curve of 86.0%. Twenty-one features were analyzed, from which feeding plan, breastfeeding at 1 month, marriage period, maternal prenatal weight, self-respect, alcohol consumption, grit, value placed on children, maternal age, and depression emerged as important predictors of exclusive breastfeeding in the first 3 months.
Discussion
A robust model was developed to predict exclusive breastfeeding that identified feeding planning and breastfeeding at 1 month as the most influential predictors. The model could be implemented in clinical and community settings to guide tailored breastfeeding support strategies, coupled with the integration of maternal self-respect, grit, and the value placed on children in counseling programs to promote exclusive breastfeeding.

1,788 View
177 Download

Job stress levels and coping among hospital nurses: a latent profile analysis: Myungji Kim, Hyunkyung Choi; J Korean Acad Nurs 2025;55(3):377-387. Published online August 22, 2025; DOI: https://doi.org/10.4040/jkan.25061

Abstract PDF ePub: Purpose
This study aimed to identify job stress levels and coping profiles among hospital nurses, explore the factors influencing profile classification, and determine whether levels of job embeddedness and happiness varied among the profiles.
Methods
Data were collected through an online survey of 325 hospital nurses, and latent profiles were identified via latent profile analysis. The R3STEP (three-step auxiliary variable approach) method was used to examine the factors influencing the latent profiles, and one-way analysis of variance was conducted to analyze differences in levels of job embeddedness and happiness.
Results
Three job stress and coping profiles were identified: (1) the “moderate stress-balanced coping group”, characterized by moderate levels of job stress and moderate use of all coping strategies; (2) the “high stress-emotional coping group”, with high job stress and primary use of emotional display strategies; and (3) the “low stress-adaptive coping group, with low job stress and the utilization of a variety of coping strategies. Workplace location and monthly income influenced the classification of latent profiles. Nurses working in metropolitan areas and those with lower monthly incomes were more likely to be classified into the high stress-emotional coping group than other groups. The levels of job embeddedness and happiness were highest in the low stress-adaptive coping group and lowest in the high stress-emotional coping group.
Conclusion
The results of this study indicate the need to develop strategies that offer diverse stress-coping programs and support nurses in effectively utilizing coping methods that best suit their individual needs.

2,048 View
227 Download

Effects of an agro-healing program on depression, stress, and cognitive function in older adults: a quasi-experimental study: Gyu Yeon Park, Kwang Ok Lee; J Korean Acad Nurs 2025;55(3):342-352. Published online August 21, 2025; DOI: https://doi.org/10.4040/jkan.25058

Abstract PDF ePub: Purpose
This study aimed to evaluate the effects of an agro-healing program on depression, stress, and cognitive function in older adults.
Methods
A quasi-experimental, nonequivalent control group pretest–posttest design was used. The study was conducted from July 16 to September 6, 2024. Sixty-two individuals aged 65 or older residing in Gimcheon, Gyeongsangbuk-do, were recruited according to the selection criteria (31 in the experimental group and 31 in the control group). The final analysis included 30 participants in each group. The program was delivered by one main instructor (a healing farmer) and three assistants. The pretest assessed general characteristics, the Geriatric Depression Scale Short Form-Korean Version, Stress Response Inventory-Modified Form, and Cognitive Impairment Screening Test. The experimental group participated in the agro-healing program once a week for 90 minutes over 8 weeks. The posttest included the same measurements as the pretest. Data were analyzed using IBM SPSS ver. 23.0.
Results
The experimental group, which participated in the healing agriculture program, showed reduced depression (F=7.97, p=.007) and stress (F=282.70, p<.001) and improved cognitive function (F=10.12, p=.002) compared to the control group.
Conclusion
The findings suggest that the agro-healing program is an effective intervention for reducing depression and stress and improving cognitive function in older adults. We propose its use to promote health and prevent dementia in this population.

2,863 View
233 Download

Comparison of educational needs and priorities for work-related laws between hospital and community-based nurses: Jeonghyun Kim, Min Kyoung Han, Minjae Lee, Sujin Shin; J Korean Acad Nurs 2025;55(3):400-412. Published online August 21, 2025; DOI: https://doi.org/10.4040/jkan.25049

Abstract PDF ePub: Purpose
This study aimed to examine the practical utilization of work-related laws in nursing practice and to prioritize educational needs to provide foundational data for improving nurses’ legal competencies.
Methods
A descriptive survey was employed using an online self-reported questionnaire. Participants included 275 nurses with over 3 years of clinical experience, categorized into hospital and community-based. Convenience sampling was used, and data were collected between January 9 and February 3, 2025. Descriptive statistics and the paired t-test were conducted using IBM SPSS 26.0. Educational needs were analyzed using the Borich Needs Assessment and the Locus for Focus model.
Results
Among participants, 75.6% had received education on work-related laws, and 79.3% of those participants received related education during their undergraduate studies. However, 32.4% of nurses reported experiencing practice related difficulties due to insufficient legal knowledge, particularly related to unclear legal responsibilities and ambiguity in the scope of practice. High educational needs were identified for the Nursing Act and the Labor Standards Act across all workplaces. Hospital nurses emphasized the Hospice and Palliative Care Act and Emergency Medical Services Act, while community-based nurses prioritized the Mental Health Welfare Act, Elderly Welfare Act, and Dementia Management Act.
Conclusion
Nurses’ legal education needs are related to practical applications and their capability to respond appropriately to legal requirements, and these needs vary depending on their work environment and social changes. These findings underscore the necessity of restructuring legal education curricula to improve practical relevance and support nurses’ rights, providing a basis for developing workplace-specific legal education programs.

2,046 View
148 Download

Development of a scale to measure fear of falling in older adults: a psychometric validation study: Dayeon Lee, Sunghee H Tak; J Korean Acad Nurs 2025;55(3):413-424. Published online August 21, 2025; DOI: https://doi.org/10.4040/jkan.25036

Abstract PDF ePub: Purpose
This study aimed to develop a scale to measure fear of falling in older adults and to validate its reliability and validity.
Methods
In total, 31 initial items were developed by referring to expressions from previous studies and items from existing instruments. After verifying content validity through expert evaluation, the remaining 27 items were used to construct a survey. Data from 252 participants recruited at three senior welfare centers in the metropolitan area were analyzed to examine item analysis, construct validity, convergent validity, discriminant validity, and reliability. Confirmatory factor analysis (CFA) was conducted to test construct validity. The correlation with the Korean version of the Falls Efficacy Scale-International (KFES-I) was used to assess convergent validity. Cronbach’s alpha was calculated to determine reliability.
Results
The final instrument consisted of 21 items. CFA confirmed acceptable model fit. Convergent validity was also acceptable and discriminant validity was partially supported. Correlations with the KFES-I ranged from .54 to .63. The Cronbach’s alpha coefficients for the total score and all factors ranged from .84 to .97.
Conclusion
The Fear of Falling Scale for Older Adults developed in this study is a validated tool capable of measuring various dimensions of fear of falling. It provides a foundation for accurately assessing fear of falling in older adults and addressing its specific aspects.

1,358 View
166 Download

Prenatal psychosocial factors and postpartum post-traumatic stress disorder in low-risk postnatal women: a longitudinal study: Jung Hee Yeo, So Yeon Park; J Korean Acad Nurs 2025;55(3):353-363. Published online August 21, 2025; DOI: https://doi.org/10.4040/jkan.25027

Abstract PDF ePub: Purpose
This study aimed to identify prenatal psychosocial factors influencing the development of postpartum post-traumatic stress disorder (PTSD) in both short-term (4–6 weeks postpartum) and long-term (4–6 and 14–18 weeks postpartum) assessments using the wheel model.
Methods
This study employed a longitudinal design with 359 women in their third trimester who received care at two maternity hospitals in City B. Surveys were used to measure depression, anxiety, resilience, and pregnancy-related PTSD during the third trimester (n=318). Postpartum PTSD was assessed at 4–6 weeks (n=198) and at 14–18 weeks postpartum (n=156). Data were analyzed using the t-test, chi-square test, and logistic regression.
Results
The prevalence of short-term postpartum PTSD was 32.7%, and that of long-term PTSD was 19.9%. The risk of short-term PTSD increased with higher pregnancy-related PTSD symptoms (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02–1.07), higher prenatal resilience (OR, 1.09; 95% CI, 1.00–1.18), and lower social support (OR, 0.93; 95% CI, 0.87–0.99). Similarly, the risk of long-term PTSD increased with higher pregnancy-related PTSD (OR, 1.09; 95% CI, 1.04–1.13), higher prenatal resilience (OR, 1.19; 95% CI, 1.06–1.34), and low educational attainment (OR, 6.75; 95% CI, 1.03–44.30).
Conclusion
The high prevalence of short- and long-term postpartum PTSD highlights the need for systematic screening and interventions for prenatal factors, including pregnancy-related PTSD, social support, resilience, and education level. Therefore, it is necessary to alleviate pregnancy-related PTSD and strengthen social support during prenatal care to prevent postpartum PTSD. Furthermore, women with high resilience should also be targeted in these interventions, because they can also develop postpartum PTSD.

1,455 View
145 Download

Effects of social support on organizational commitment among experienced nurses experiencing department rotation: the mediating effect of organizational socialization: Young Jun Jang, Jeong A Jeong, Yu Seung Ban, Seon Hwa Park, Eun Jee Lee; J Korean Acad Nurs 2025;55(3):364-376. Published online August 18, 2025; DOI: https://doi.org/10.4040/jkan.25042

Abstract PDF ePub

Purpose
This study explored the mediating role of organizational socialization in the relationship between social support and organizational commitment among nurses in hospitals who had experienced department rotation.
Methods
A descriptive survey design was used with 202 nurses from a tertiary hospital who had experienced department rotation within the past 12 months. Data were collected via an online questionnaire from August 1 to August 30, 2024. Analyses included frequency analysis, descriptive statistics, Pearson correlation, and multiple regression. The mediating effect was tested using IBM SPSS WIN ver. 23.0 and the PROCESS macro (model 4) with 10,000 bootstrap resamples.
Results
Organizational socialization partially mediated the relationship between social support and organizational commitment (B=.21; bootstrapped 95% confidence interval, 0.12–0.32).
Conclusion
The findings suggest that both social support and organizational socialization play essential roles in improving nurses’ organizational commitment following department rotation. Thus, practical programs, such as mentoring systems, should be implemented that both enhance social support and actively promote organizational socialization. These efforts have the potential to help nurses adjust more effectively to new units and ultimately improve retention and performance within healthcare organizations.

Citations

Citations to this article as recorded by

The Effects of Nurses’ Dispatch Work Characteristics on Job Embeddedness, Organizational Commitment, and Turnover Intention
Eejee Jung, Gunjeong Lee
Journal of Korean Academy of Nursing Administration.2025; 31(5): 560. CrossRef
Nurses' Experience Working with Substitute Nurses
Hye Mi Kim, Yeon Hee Kim, Jeong Hye Kim
Journal of Korean Association for Qualitative Research.2025; 10(3): 208. CrossRef

2,084 View
236 Download
2 Crossref

Impact of an integrated disease-specific nursing care model on parental anxiety and depression in severe hypospadias patients in China: a randomized controlled trial: Ruijuan Wu, Lucai Jia, Biyu Ding, Ying Li, Yaqing Cao, Zhaojun Shi, Yanfang Yang; J Korean Acad Nurs 2025;55(3):327-341. Published online August 12, 2025; DOI: https://doi.org/10.4040/jkan.24147

Abstract PDF ePub: Purpose
This study aimed to explore the effects of an integrated disease-specific nursing care model on alleviating perioperative and post-surgical anxiety and depression in parents of children with severe hypospadias.
Methods
Parents of children with severe hypospadias were recruited and randomly allocated into a control group (n=87), which received standard nursing care, and an intervention group (n=93), which was given an integrated disease-specific nursing intervention in addition to standard care. Parental anxiety and depression were measured using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) at admission, discharge, and 6-month follow-up post-surgery.
Results
A linear mixed-effects model showed that SAS and SDS scores in the intervention group decreased to a significantly greater extent over time, from admission to follow-up, compared to the control group. Post-hoc analysis showed a trend for increased parental anxiety and depression among patients with complications at discharge and follow-up for the control group. Meanwhile, the intervention group exhibited a trend for decreased parental anxiety and depression among patients with complications at discharge and follow-up.
Conclusion
The integrated disease-specific nursing model significantly alleviated parental anxiety and depression over time compared to standard care, highlighting its effectiveness in supporting families of children with severe hypospadias. Notably, the intervention appeared to mitigate the negative emotional impact of postoperative and follow-up complications, suggesting its potential as a targeted approach to improve both emotional well-being and overall care outcomes.

2,470 View
165 Download

The experiences of infertile women discontinuing in vitro fertilization treatment: a grounded theory approach: Eunmi Park, Yeoungsuk Song; J Korean Acad Nurs 2025;55(3):440-453. Published online August 11, 2025; DOI: https://doi.org/10.4040/jkan.25048

Abstract PDF ePub: Purpose
This study aimed to develop a situation-specific theory by gaining an in-depth understanding of the deterrent processes experienced by infertile women who have discontinued in vitro fertilization (IVF) procedures, within the socio-cultural context of South Korea.
Methods
The participants were 16 infertile women who discontinued IVF procedures. Data were collected through individual in-depth interviews from February to December 2023. Theoretical sampling was conducted, and the transcribed interview contents were analyzed using Strauss and Corbin’s grounded theory method.
Results
In total, 37 concepts and 14 categories were extracted through the open coding process. The central phenomenon in axial coding was “Distress caused by the discontinuation of IVF treatment.” The core category was “A journey to break free from the identity of infertility toward self-determined womanhood.” The results were categorized into two types: “Detachment from the framework of attempting pregnancy” and “A continued longing for the fulfillment of a traditional family.” The situation-specific theory was the “Theory of reconstructing subjective identity through the acceptance of childfree life,” which illustrates how infertile women actively redefine their life trajectories after discontinuing IVF treatment.
Conclusion
This study highlights the importance of public perceptions about infertile women who discontinue IVF procedures, which are seen as the last resort of assisted reproductive technology, because positive perceptions assists women in living a self-governing life. It may be necessary to develop educational and promotional programs to change negative social perceptions and to establish a psycho-social support system for infertile women who have been deterred from IVF procedures.

1,413 View
111 Download

Research trends in generative artificial intelligence in nursing: a scoping review: Myung Jin Choi, Myoung Hee Seo, Jihun Kim, Sunmi Kim, Seok Hee Jeong; J Korean Acad Nurs 2025;55(3):468-487. Published online August 5, 2025; DOI: https://doi.org/10.4040/jkan.25006

Abstract PDF ePub

Purpose
Generative artificial intelligence (AI) has yet to be comprehensively analyzed in the nursing literature. This study aimed to identify research trends in generative AI within the nursing field through a scoping review and propose strategies for its effective utilization in nursing.
Methods
A scoping review was conducted following Arksey and O’Malley’s six-stage framework. The inclusion criteria included: (1) studies conducted in nursing; (2) research related to generative AI; and (3) original research articles, theses, communications, editorials, letters, or commentaries published in academic journals. Database used PubMed, Embase, CENTRAL, CINAHL, KMbase, KoreaMed, KISS, ScienceON, RISS, DBpia, and 27 nursing-specific journals.
Results
In total, 403 studies were initially identified, and 58 were included in the final analysis. In the care domain, strengths included rapid information retrieval and improved nurse-patient communication, while limitations included the irreplaceable human element and low reliability. The administration domain had no relevant studies. In the research domain, generative AI exhibited strengths such as enhanced efficiency in the paper writing process and improved dissemination speed, but its weaknesses included lack of ethical and legal accountability and a risk of inaccurate or biased information. In the education domain, generative AI was effective in saving time in educational design and implementation, as well as supporting content creation, but challenges included algorithmic bias and risks of plagiarism.
Conclusion
This study identified potential benefits and limitations of generative AI across nursing domains. For effective application, it is essential to develop comprehensive guidelines and policies, provide user education and support, and create opportunities for nurses, educators, and students to learn about strengths and risks of generative AI.

Citations

Citations to this article as recorded by

Nursing Students' Perspectives on the Use of Artificial Intelligence in Psychiatric Nursing Education: A Qualitative Meta-Synthesis
Sukyung Son, Eunyoung Park
Journal of Korean Academy of psychiatric and Mental Health Nursing.2025; 34(Special Is): 9. CrossRef

6,930 View
506 Download
1 Crossref

Work system analysis of health management for individuals with disabilities in supportive housing: a focus group study using the SEIPS framework: Haesun Lee, Hye Jin Nam, Bohye Kim, Ju Young Yoon; J Korean Acad Nurs 2025;55(3):454-467. Published online August 4, 2025; DOI: https://doi.org/10.4040/jkan.25018

Abstract PDF ePub: Purpose
This study conducted a work-system analysis using the Systems Engineering Initiative for Patient Safety (SEIPS) framework to assess the flow of health-related information, and the current status of health management tasks for individuals with disabilities (IWD) in supportive housing.
Methods
This qualitative study utilized focus groups. Participants included a head of supportive housing, a team leader, a care coordinator and three personal support workers for IWD. Semi-structured interviews were guided by the SEIPS framework to explore the components of persons, tasks, tools and technology, organization, and environments.
Results
This study identified five key themes within the five SEIPS components: (1) disparities in role identity and health literacy among staff, (2) challenges in health care support reflecting a person-centered approach, (3) barriers in health-related information exchange and communication tools, (4) needs for organizational strategies or information communication, and (5) needs for integrating health-related information across external healthcare institutions. Additionally, 10 sub-themes were identified.
Conclusions
These findings provide a comprehensive system-wide perspective and offer insights into the systematic approaches needed to improve healthcare processes and structures within disability supportive housing. Specifically, healthcare providers and effective tools for integrating health-related information are identified as critical components.

1,451 View
89 Download

Life changes following trauma in female burn survivors: a narrative inquiry: Riah Kim, Inyoung Choe, Ji-Su Yun, Heeseung Choi; J Korean Acad Nurs 2025;55(3):425-439. Published online August 1, 2025; DOI: https://doi.org/10.4040/jkan.25003

Abstract PDF ePub: Purpose
Burn survivors endure repeated exposure to intense pain and face recurring trauma throughout social adaptation. This study explored how female burn survivors construct the meaning of their traumatic experience of a burn accident and the subsequent changes in their lives.
Methods
A qualitative study was conducted using narrative inquiry. Participants were recruited through purposive sampling, and each engaged in three in-depth interviews, resulting in a total of 21 interviews between April 18, 2024, and August 1, 2024. Each interview lasted 90 minutes on average and was conducted in a comfortable location preferred by the participants. The collected data were analyzed through Connelly and Clandinin’s approach.
Results
The participants were seven women with burns on the full body, face-upper limbs, or face-torso. All burns were third- to fourth-degree, and most participants had lived with these injuries for over 10 years. From the significant statements, five themes and 12 subthemes were extracted. The five themes were “unforeseen catastrophe,” “burn scars encroaching upon daily life,” “navigating life as an incomplete woman,” “exclusion from social integration,” and “the meaning of life deepened by suppressed pain.”
Conclusion
Female burn survivors experienced immense hardships following their accidents. However, through their recovery efforts, they found new meaning in life, experienced a renewed sense of being alive, and achieved inner growth and maturity. This study highlights the need for social support and underscores the importance of providing various opportunities and policy assistance for female burn survivors dealing with trauma.

1,979 View
112 Download

Media discourse on physician assistant nurses in South Korea: a text network and topic modeling approach: Young Gyu Kwon, Daun Jeong, Song Hee Park, Mi Kyung Kim, Chan Woong Kim; J Korean Acad Nurs 2025;55(3):388-399. Published online July 30, 2025; DOI: https://doi.org/10.4040/jkan.25038

Abstract PDF ePub

Purpose
This study quantitatively examined the portrayal of physician assistant (PA) nurses in Korean media by integrating text network analysis with latent Dirichlet allocation (LDA) topic modeling.
Methods
A total of 3,564 news articles published by nine major Korean media outlets between 2020 and 2024 were analyzed. Content analysis was conducted using term frequency-inverse document frequency calculations, network centrality analysis, and LDA topic modeling to extract key terms, map discourse structures, and identify latent topics.
Results
The analysis identified four primary topics in Korean media discourse: “healthcare workforce expansion policies” (30.4%), “hospital clinical practice and operational management” (23.5%), “institutionalization of the PA nursing role” (17.8%), and “COVID-19 response and public health crisis management” (28.3%). High-centrality keywords included “hospital,” “medical,” “patient,” “physician,” “government,” and “nurse,” indicating that the discourse primarily focused on clinical settings. Topic modeling revealed a major shift from pandemic-centered coverage in 2020 to a focus on healthcare workforce policy and PA nurse institutionalization in 2024, coinciding with the passage of the Nursing Act.
Conclusion
This study provides empirical evidence suggesting that the portrayal of PA nurses in Korean media discourse evolved from a peripheral regulatory issue to a central healthcare delivery solution, particularly in the contexts of workforce management, clinical practice, and crisis response. Our findings suggest that PA nurse institutionalization received broader attention when positioned as part of systemic healthcare improvements addressing concrete clinical needs. These results offer valuable insights for policymakers and administrators in framing and implementing workforce policy reforms.

Citations

Citations to this article as recorded by

Impact of role conflict and job stress on turnover intention among Korean physician assistant nurses: A cross-sectional study
Jin-Won Lee, Eun-Hi Choi, Ji-Sun Back
International Journal of Nursing Sciences.2026;[Epub] CrossRef

3,468 View
118 Download
1 Crossref

A review of domestic and international contexts for establishing a communication platform for early-career nurse scientists: Jeung-Im Kim, Jin-Hee Park, Hye Young Kim, Mi Yu, Sun Joo Jang, Yeonsoo Jang, Sangeun Jun; J Korean Acad Nurs 2025;55(2):317-325. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.25041

Abstract PDF ePub: Purpose
As nursing continues to advance through digital health, clinical specialization, and interdisciplinary research, early-career nurse scientists are central to advancing innovation. However, Korea lacks a structured platform to support their research, collaboration, and career development. This review aimed to identify the needs of early-career nurse scientists and examine international best practices to guide the creation of an effective communication platform.
Methods
This study involved a secondary analysis of the final report from the project “Establishment of a communication platform for young nursing scientists,” carried out by the Korean Society of Nursing Science. The report comprises data from focus group interviews with domestic graduate students and early-career researchers, a literature review of international communication and support systems, and a global policy analysis related to young nursing scientists. Based on this report, the present review synthesizes key findings and draws implications for the development of a communication platform in Korea.
Results
International examples, such as grant writing programs, mentoring initiatives, and digital collaboration hubs, showed positive outcomes in strengthening research capacity and promoting the professional growth of nurse scientists. Based on these findings, key considerations for platform development include: (1) establishing clear leadership and a participatory governance model; (2) providing demand-driven content such as research guides, mentoring, and mental health resources; (3) implementing mechanisms to ensure sustainability, content quality, and user data protection; and (4) designing an integrated platform that fosters synergy across research, policy development, education, and global networking.
Conclusion
A digital platform for early-career nurse scientists should function not merely as an information portal, but also as dynamic infrastructure for collaboration, mentorship, and growth. It is recommended that the Korean Society of Nursing Science spearhead this initiative, with governmental support, to enhance the research capacity and expand the global engagement of Korean nursing scientists.

2,374 View
80 Download

Core domains for pre-registered nurses based on program outcomes and licensing competencies: Soyoung Yu, Hye Young Kim, Jeung-Im Kim, JuHee Lee, Ju-Eun Song, Hyang Yuol Lee; J Korean Acad Nurs 2025;55(2):249-268. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.25017

Abstract PDF ePub: Purpose
This study aimed to identify core domains for pre-registered nurses by comparing licensing competencies with program outcomes (POs) in undergraduate nursing education. This was accomplished in preparation for the transition of the Korean Nurse Licensing Examination (KNLE) from a tradition seven-subject format to a newly integrated, competency-based single-subject format that reflects current trends in nursing assessment.
Methods
A literature review and survey were conducted. From 828 studies retrieved via PubMed, CINAHL, and Google Scholar using keywords such as “newly graduated registered nurses” and “competency OR competence,” 18 were selected according to pre-established inclusion and exclusion criteria. Documents from national and international nursing organizations were included to extract relevant licensing competencies. We also reviewed POs from all undergraduate nursing schools in South Korea to align educational outcomes with the identified core domains.
Results
The core domains identified were clinical performance and decision-making, professional attitudes and ethics, communication and interpersonal skills, leadership and teamwork, quality improvement and safety, health promotion and prevention, and information technology and digital health. These domains showed strong alignment with POs under the fourth-cycle accreditation standards.
Conclusion
It concludes the seven core domains will be appropriate for evaluating pre-registered nurses in the integrated KNLE. Based on the seven identified core domains, expert consensus should be sought in the next phase to support the development of integrated, competency-based test items grounded in these domains.

4,073 View
156 Download

Effectiveness of a mobile application for tracking symptoms and enhancing symptom management among breast cancer patients receiving chemotherapy in Bangkok, Thailand: a non-randomized controlled trial: Duangrat Kaveenuntachai, Supawan Jaiboon, Bualuang Sumdaengrit, Chureeporn Silaguntsuti, Arveewan Vittayatigonnasak, Pornchan Sailamai; J Korean Acad Nurs 2025;55(2):178-190. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.25011

Abstract PDF ePub

Purpose
This study evaluated the effectiveness of a mobile application in tracking symptoms and improving symptom management and quality of life (QoL) among breast cancer patients undergoing chemotherapy in Thailand.
Methods
A non-randomized controlled trial was used, with 25 participants in the intervention group and 25 in the control group. Research instruments included a demographic data form, the NCI-PRO-CTCAE Items-Thai-Thailand version 1.0, and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire and Breast Cancer-Specific Module.
Results
The intervention group had significantly less severe side effects than the control group, with mean differences of –23.33 (95% confidence interval [CI], –27.82 to –18.83) on day 1, –28.18 (95% CI, –33.22 to –23.14) on day 3, –34.63 (95% CI, –40.18 to –29.08) on day 7, –42.56 (95% CI, –48.72 to –36.40) on day 14, and –51.31 (95% CI, –58.13 to –44.48) on day 21 (p<.001 for all). On day 21, participants in the intervention group reported significantly higher scores in the Global Health QoL and Functional Scales compared to the control group (p<.001). Additionally, intervention group participants reported lower scores on the Symptom Scales and higher scores on the Functional Scales than those in the control group (p<.001).
Conclusion
The ChemoPro application helped manage chemotherapy-related symptoms and was associated with improved symptom monitoring and QoL. Nonetheless, the study was limited by a small sample size and restriction to Android users. Future research with larger and more diverse populations is recommended before broader implementation in clinical practice.

Citations

Citations to this article as recorded by

Effectiveness of a digital health intervention on the supportive care needs and quality of life in Mexican patients with breast cancer: a randomized clinical trial
Saúl Eduardo Contreras-Sánchez, Svetlana V. Doubova, Rocío Grajales-Álvarez, Ricardo Villalobos-Valencia, Abdel Karim Dip-Borunda, José Gustavo Nuñez-Cerrillo, Alma Diana Huerta-López, Álvaro José Montiel-Jarquín, Arturo García-Galicia, Enrique Isay Talam
BMC Cancer.2026;[Epub] CrossRef

4,259 View
215 Download
1 Crossref

Development of a communication self-efficacy scale for nurses: a psychometric validation study: Kuem Sun Han, Jihye Shin, Soo Yeon Lee; J Korean Acad Nurs 2025;55(2):269-284. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.24129

Abstract PDF ePub: Purpose
This methodological study was conducted to develop a scale to measure communication self-efficacy in nurses and examine its validity and reliability.
Methods
We selected 54 initial items from literature reviews and interviews with 10 clinical nurses. Thirty-two preliminary items were derived from consultations with 10 experts. To verify the scale’s factor structure, we conducted exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) among 469 nurses. Data were analyzed using item analysis, EFA, CFA, discriminant validity, convergent validity, and internal consistency using IBM SPSS Statistics ver. 29.0 (IBM Corp.) and IBM SPSS AMOS ver. 20.0 (IBM Corp.).
Results
The scale consisted of 18 items with three factors (ability to apply therapeutic communication skills, crisis management capabilities, and communication competence), which explained 46.1% of the total variance. Convergent validity and discriminant validity were confirmed for the factors. CFA supported the fit of the measurement model comprising three factors (standardized root mean square residual=.04, root mean square error of approximation=.03, goodness of fit index=.92, Tucker-Lewis index=.97, comparative fit index=.98, normed fit index=.89, critical N=216). Internal consistency was confirmed by a Cronbach’s α coefficient of .91.
Conclusion
The communication self-efficacy scale for nurses is expected to measure communication self-efficacy among nurses. It will be useful for improving nurses’ professional communication abilities.

3,575 View
272 Download

Successful aging among the elderly with mild cognitive impairment facing the crisis of old age: a grounded theory study: Haeyun Shin, Suhye Kwon; J Korean Acad Nurs 2025;55(2):301-316. Published online May 27, 2025; DOI: https://doi.org/10.4040/jkan.24114

Abstract PDF ePub: Purpose
The purpose of this study was to understand experiences of successful aging experience in older adults with mild cognitive impairment.
Methods
The participants were 15 older adults with mild cognitive impairment who had experienced successful aging. Data were collected from January to October 2021 through individual deep, unstructured interviews. Data analysis was performed using Charmaz’s grounded theory method. In addition, the consolidated criteria for reporting qualitative research checklist was used to ensure the quality of the study.
Results
The key category representing experiences of successful aging experience in older adults with mild cognitive impairment was “raising oneself up in the unsettling crisis of old age.” Four stages were derived: “feeling anguished due to the strange signals of memory,” “being shaken by fading memory,” “maintaining balance for a healthy old age,” and “recovering the composure of old age.”
Conclusion
Participants tried to successfully achieve aging while implementing their own plans and strategies in the midst of the challenges of old age, when the mind and body were unsettled by mild cognitive impairment. The results of this study provide a deep understanding of experiences of successful aging in older adults with mild cognitive impairment, potentially contributing to the development and implement of nursing intervention programs to promote the successful pursuit of aging in this population.

2,257 View
113 Download

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.

3,343 View
243 Download

Analysis of the relative importance of key factors in nursing workforce management for pandemic response in general hospitals and long-term care hospitals: Jeong Eun Cha, Eun Kyoung Yun; J Korean Acad Nurs 2025;55(2):236-248. Published online May 14, 2025; DOI: https://doi.org/10.4040/jkan.24112

Abstract PDF ePub: Purpose
This study aimed to identify the key factors in nursing workforce management for pandemic response in general hospitals and long-term care hospitals and to analyze the relative importance of these factors.
Methods
A validity test was conducted with experts to select four categories and 30 key factors related to nursing workforce management for pandemic response. Surveys were collected from 25 nursing managers in general hospitals and 21 nursing managers in long-term care hospitals, and the relative importance of the key factors was analyzed using the analytic hierarchy process method.
Results
Differences were found between the two groups in the relative importance of nursing workforce management for pandemic response. Specifically, the highest-ranking category was “workforce recruitment and redeployment” for general hospitals, but “workforce support and protection” for long-term care hospitals. The most important factor regarding nursing workforce management was the “nurse-to-patient ratio” for both general and long-term care hospitals.
Conclusion
General and long-term care hospitals need to establish nursing workforce management strategies to effectively respond to pandemics with appropriate consideration of the relative importance and prioritization of key factors based on hospital characteristics.

1,958 View
74 Download

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.

Citations

Citations to this article as recorded by

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

2,373 View
249 Download
1 Web of Science
1 Crossref

Impact of smoking on diabetes complications: a secondary analysis of the Korean National Health Insurance Service-health screening cohort (2002–2019): Seonmi Yeom, Youngran Yang; J Korean Acad Nurs 2025;55(2):222-235. Published online April 21, 2025; DOI: https://doi.org/10.4040/jkan.24109

Abstract PDF ePub: Purpose
This study aimed to examine the effects of smoking on the incidence of macrovascular and microvascular complications in patients with type 2 diabetes.
Methods
We analyzed 35,804 patients diagnosed with type 2 diabetes between 2004 and 2017 using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019). Smoking status was categorized into never, former, and current smoking, with further classification based on duration of smoking and daily smoking amount. We conducted survival analysis using a Cox proportional hazards model.
Results
Both former and current smokers had significantly elevated risks of macrovascular complications compared to non-smokers, with hazard ratios (HRs) of 1.60 (95% confidence interval [CI], 1.49–1.66) and 1.10 (95% CI, 1.08–1.17), respectively. Long-term smokers (over 30 years) had significantly higher risks of both macrovascular (HR, 1.35; 95% CI, 1.29–1.42) and microvascular complications (HR, 1.36; 95% CI, 1.30–1.42). Heavy smokers (over 2 packs/day) more frequently developed macrovascular (HR, 1.46; 95% CI, 1.30–1.64) and microvascular (HR, 1.78; 95% CI, 1.60–1.98) complications than never smokers. Notably, former smokers had increased risks of developing neuropathy (HR, 1.40; 95% CI, 1.31–1.49), nephropathy (HR, 1.27; 95% CI, 1.16–1.39), and retinopathy (HR, 1.49; 95% CI, 1.39–1.60).
Conclusion
Patients with type 2 diabetes and a history of smoking are at higher risk of developing macrovascular and microvascular complications. Smoking cessation, along with reducing smoking duration and amount, is crucial for lowering these risks.

2,103 View
120 Download

The effects of a lifestyle intervention for men in infertile couples in South Korea: a non-randomized controlled trial: Yun Mi Kim, Ju-Hee Nho; J Korean Acad Nurs 2025;55(2):191-204. Published online April 16, 2025; DOI: https://doi.org/10.4040/jkan.24104

Abstract PDF ePub

Purpose
This study aimed to evaluate the effects of an interaction model of client health behavior (IMCHB)-based lifestyle intervention on health-promoting behaviors, infertility stress, fertility-related quality of life, and semen quality in men in infertile couples.
Methods
This study used a quasi-experimental, non-equivalent control group, pretest-posttest design, with participants divided into an experimental group (n=17) and a control group (n=19). The 16-session, 8-week intervention included components such as reproductive health education, physical activity, nutritional management, and stress management. Data collection occurred between July 1, 2021 and September 27, 2022. The outcomes measured included health-promoting behaviors, infertility stress, fertility-related quality of life, and sperm quality (volume, total motility, immobility, concentration, and normal morphology).
Results
The experimental group showed significant improvements in health-promoting behaviors (z=–2.27, p=.023) and reductions in infertility stress (t=–2.40, p=.022) compared to the control group. Total sperm motility (F=4.39, p=.045) and normal morphology (z=2.86, p=.017) were also significantly higher in the experimental group than in the control group.
Conclusion
The IMCHB-based lifestyle intervention significantly increased health-promoting behaviors, reduced infertility stress, and improved key sperm parameters, indicating its effectiveness in supporting the reproductive health of men in infertile couples.

Citations

Citations to this article as recorded by

Psychological Stress and Male Infertility: Oxidative Stress as the Common Downstream Pathway
Aris Kaltsas, Stamatis Papaharitou, Fotios Dimitriadis, Michael Chrisofos, Nikolaos Sofikitis
Biomedicines.2026; 14(2): 259. CrossRef

3,658 View
139 Download
1 Crossref

Triglyceride-glucose parameters as predictors of diabetes mellitus incidence in Korean adults: a secondary analysis of a Prospective Cohort Study: Yu Jin Park, Miseon Shin, Hyun Seon Jeon, Eun Hee Yang; J Korean Acad Nurs 2025;55(2):205-221. Published online April 1, 2025; DOI: https://doi.org/10.4040/jkan.24108

Abstract PDF ePub: Purpose
This study aimed to evaluate the association between triglyceride-glucose (TyG)–related parameters and the incidence of diabetes mellitus in Korean adults. Data were obtained from the Korean Genome and Epidemiology Study (KoGES).
Methods
This secondary analysis examined data from 6,816 adults aged 40–69 years who participated in the KoGES from 2001 to 2020. TyG–related parameters, including the TyG index, TyG–body mass index (TyG–BMI), TyG–waist circumference (TyG–WC), and TyG–waist-to-height ratio (TyG–WHtR), were assessed. Cox proportional hazards models were employed to determine the association between these parameters and the incidence of diabetes mellitus, with adjustments made for demographic, lifestyle, and health-related characteristics.
Results
Higher levels of all TyG–related parameters were significantly associated with an increased risk of developing diabetes mellitus. Specifically, participants in the highest quartile of the TyG index, TyG–BMI, TyG–WC, and TyG–WHtR exhibited significantly higher hazard ratios for diabetes mellitus incidence compared with those in the lowest quartile (p<.001 for all). Notably, the TyG index demonstrated a stronger predictive value for diabetes mellitus than traditional measures such as the homeostatic model assessment of insulin resistance.
Conclusion
TyG–related parameters are robust predictors of diabetes mellitus incidence in Korean adults. These findings support the incorporation of TyG–related measures into clinical settings for the early identification and intervention of high-risk populations. Utilizing these parameters for early diagnosis and preventive strategies may significantly enhance diabetes mellitus management.

2,442 View
154 Download

Development of a well-dying awareness scale for middle-aged adults in Korea: a mixed-methods study: Yu Jin Jung, Eun Joung Choi; J Korean Acad Nurs 2025;55(2):285-300. Published online March 28, 2025; DOI: https://doi.org/10.4040/jkan.24121

Abstract PDF ePub: Purpose
This study aimed to develop a valid and reliable tool to measure awareness of well-dying among middle-aged adults.
Methods
A mixed-methods approach was adopted, consisting of a qualitative phase to identify the characteristics of well-dying and a quantitative phase to validate the instrument with middle-aged participants. Initially, 76 items were generated through a literature review and in-depth interviews, and these were reduced to 35 items through expert validation. A pilot survey was conducted with 112 individuals aged 40–65, selected via quota sampling from 17 administrative regions in South Korea. Based on the pilot survey results, the instrument was refined to 32 items for the main survey. The main survey included 314 participants recruited through quota sampling in Busan and Ulsan Metropolitan Cities and Gyeongsang Region. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing were performed to validate the instrument.
Results
The final scale comprised 23 items across six factors. EFA demonstrated an explanatory power of 69.1%, with factor loadings ranging from 0.53 to 0.88. CFA confirmed the instrument’s validity, and reliability was established with a Cronbach’s α of .93.
Conclusion
This instrument is a validated and reliable tool for measuring middle-aged individuals’ awareness of well-dying. It can serve as an effective resource for evaluating and assessing well-dying awareness in the middle-aged population.

2,918 View
200 Download

Effects of a nursing leadership program on self-leadership, interpersonal relationships, clinical performance, problem-solving abilities, and nursing professionalism among nursing students in South Korea: a quasi-experimental study: Sunmi Kim, Young Ju Jeong, Hee Sun Kim, Seok Hee Jeong, Eun Jee Lee; J Korean Acad Nurs 2025;55(1):137-151. Published online February 25, 2025; DOI: https://doi.org/10.4040/jkan.24110

Abstract PDF ePub

Purpose
This study investigated the effects of a nursing leadership program on self-leadership, interpersonal relationships, clinical performance, problem-solving abilities, and nursing professionalism among nursing students in South Korea.
Methods
A quasi-experimental study was conducted. The Practice-Driven Nursing Leadership Program for Students (PDNLP-S) was developed based on the ADDIE model (analysis, design, development, implementation, and evaluation). This quasi-experimental study design included 60 nursing students. The experimental group (n=30) participated in the PDNLP-S for 120-minute sessions over 5 weeks, while the control group (n=30) received usual lectures. The PDNLP-S included lectures, discussions, and individual and group activities to cultivate core nursing leadership competencies such as individual growth, collaboration, nursing excellence, creative problem-solving, and influence. Data were analyzed using descriptive statistics, the Mann-Whitney U-test, and the independent t-test with IBM SPSS Windows ver. 26.0.
Results
The experimental group demonstrated significant improvements in self-leadership (t=3.28, p=.001), interpersonal relationships (t=3.07, p=.002), clinical performance (U=268.50, p=.004), and problem-solving abilities (t=2.20, p=.017) compared to the control group. No significant difference was observed in nursing professionalism (t=0.50, p=.311).
Conclusion
This study demonstrates that the PDNLP-S improved nursing students’ self-leadership, interpersonal relationships, clinical performance, and problem-solving abilities. The PDNLP-S can play a significant role in cultivating future nurse leaders by enhancing these nursing leadership competencies among nursing students.

Citations

Citations to this article as recorded by

Self-Determination Theory in Return to Work Interventions: A Scoping Review
Kexin Chen, Ling Yang, Jiajia Tu
Journal of Multidisciplinary Healthcare.2025; Volume 18: 7539. CrossRef

7,378 View
300 Download
1 Web of Science
1 Crossref

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).

4,782 View
354 Download

Reliability and validity of the Korean version of the Nurses Professional Values Scale-3 for nursing students: a methodological study: Eun Hee Yang, Mi Yu; J Korean Acad Nurs 2025;55(1):93-106. Published online February 20, 2025; DOI: https://doi.org/10.4040/jkan.24113

Abstract PDF ePub: Purpose
This study aimed to adapt the Nurses Professional Values Scale-3 (NPVS-3) for Korean nursing students and assess its reliability and validity.
Methods
The NPVS-3 was translated into Korean using forward and back translation with expert review. Data from 206 nursing students at four universities were analyzed to assess content, construct, discriminant, and criterion validity, as well as internal consistency.
Results
The Korean version (NPVS-3K) consisted of 21 items in three subscales: caring (eight items), activism (eight items), and professionalism (five items), explaining 60.9% of the total variance. For convergent validity, standardized coefficients for the items ranged from .56 to .81, construct reliability ranged from .89 to .95, and the average variance extracted ranged from .61 to .72. The model was validated by confirmatory factor analysis (χ2=526.00 [p<.001], χ2/degrees of freedom=2.83, standardized root mean residual=.03, goodness of fit index=.81, comparative fit index=.87, Turker Lewis index=.85). Discriminant validity was confirmed using a multi-trait and multi-item matrix. Criterion validity showed positive correlations between the three NPVS-3K factors and professional identity (factor 1: r=.40, p<.001; factor 2: r=.55, p<.001; factor 3: r=.43, p<.001). Internal consistency, as measured by Cronbach’s α, was .94 overall, with subscale values of .90 for caring, .92 for activism, and .78 for professionalism.
Conclusion
The NPVS-3K demonstrated satisfactory validity and reliability, establishing it as a valuable tool for assessing the professional values of Korean nursing students. Additionally, it can aid in developing educational strategies to strengthen these values, although further research is required to confirm its broader applicability.

4,321 View
349 Download

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.

3,720 View
195 Download

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.

5,405 View
468 Download

Search