Introduction

Stroke represents a major public health burden worldwide. The World Stroke Organization estimates that almost 12 million people experience a new stroke each year and that one in four adults aged ≥25 years will suffer a stroke during their lifetime [1]. In Korea, the number of stroke patients increased by approximately 7.5%, from 607,862 in 2020 to 653,275 in 2024 [2], reflecting an aging population and improved survival rates.

Aphasia is one of the most disabling consequences of stroke, resulting from damage to language-dominant cortical and subcortical regions. Patients may experience difficulties with speaking, understanding, reading, writing, and symbol recognition [3]. Analysis of more than 4 million admissions for acute ischemic stroke in the US National Inpatient Sample revealed that 16.9% of patients had aphasia, with the proportion having increased from 13.3% in 2003 to 21.9% in 2014 [4]. A recent meta-analysis of 36 studies involving 31,058 patients reported an overall prevalence of post-stroke aphasia of 34% [5]. Data on the prevalence of aphasia in Korea remain scarce. A 2022 analysis of the Korean Stroke Cohort for Functioning and Rehabilitation found that 46.5% of stroke survivors reported experiencing communication impairments, including aphasia, 6 months after stroke onset [6]. Aphasia is associated with higher mortality rates, longer hospital stays, and increased healthcare costs [4]. Individuals with aphasia are also more likely to experience post-stroke depression; in one cohort study, the odds of depressive symptoms were over seven-fold higher in people with aphasia compared to those without [7]. Loss of language function impairs social participation and return to work, contributing to social isolation and anxiety [8].

Although spontaneous recovery occurs, language recovery is often incomplete. Prospective studies indicate that stroke survivors regain approximately 70% of their maximal potential language function within 90 days [9], with the most rapid improvements occurring within the first 2 weeks [10]. Despite this recovery pattern, many patients in the acute phase have a limited understanding of their condition and receive insufficient information about communication strategies, which hampers interactions with healthcare professionals [11]. A recent audit by the Australian Stroke Foundation, involving 3,122 patients with aphasia across 126 hospitals, reported that while those requiring interpreters had similar access to care, they were less likely to have their mood assessed, experienced longer median hospital stays, received more caregiver training, and were less likely to achieve independence at discharge [12]. These findings illustrate how communication difficulties can compromise the quality of acute care and discharge outcomes.

Although qualitative studies have begun to explore the experiences of individuals with post-stroke aphasia, most have focused on communication barriers in general. Carragher et al. [13] highlighted patients’ frustration at being perceived as cognitively impaired through the theme “I am not mad, I am not deaf,” while Loft et al. [14] emphasized patients' desire to be treated as equal human beings by healthcare professionals. However, these studies did not comprehensively address the broader range of challenges faced by patients during the acute phase. Furthermore, in Korea, stroke research has predominantly focused on physical disabilities, with limited investigation of the subjective experiences of patients with aphasia, particularly during the acute stage. Existing Korean studies have analyzed experiences of chronic aphasia [15] or healthcare providers’ perspectives on communicating with aphasic patients [16], but there remains a significant gap in research investigating the communication difficulties and actual needs of patients with acute aphasia.

Given these research gaps, we conducted a qualitative content analysis to comprehensively explore the lived experiences of patients with acute post-stroke aphasia in Korea. Qualitative content analysis enables systematic coding and thematic interpretation of participants’ narratives, providing valuable insights when prior knowledge is limited [17,18].

The purpose of this study was to gain an in-depth understanding of the experiences of patients with acute stroke-related aphasia in the Korean healthcare context. By illuminating these experiences from the patients’ perspective, this study seeks to inform healthcare professionals and contribute to the development of more patient-centered care approaches for individuals with acute aphasia. Our research question was: “What are the experiences of patients with acute stroke-related aphasia during their hospitalization?”

Methods

1. Study design

This study employed a qualitative content analysis approach. We adhered to the 32-item Consolidated Criteria for Reporting Qualitative Research checklist [19].

2. Participants

Fourteen adults with acute stroke-related aphasia who were admitted to a university hospital in Busan participated in this study. The acute phase of stroke was defined as within 7 days after onset [20]; participants were identified during this period, but interviews were conducted once their communication abilities had sufficiently improved to allow participation.

The inclusion criteria were as follows: (1) age ≥19 years; (2) ability to express thoughts and experiences through verbal or nonverbal means (e.g., gestures, writing, or simple speech despite residual impairments such as dysarthria); and (3) capacity to understand the study purpose and provide informed consent. Patients with residual language impairments were included to reflect the diversity of aphasia experiences and enhance representativeness. We excluded individuals with a history of aphasia prior to the current stroke or with pre-existing cognitive impairment.

Participants were recruited through purposive sampling. One author screened potential participants by observing patients in the stroke intensive care unit and reviewing medical records. Brief conversations were conducted to assess whether participants could communicate sufficiently for an interview. We aimed for variation in age, gender, and aphasia type. Eligible candidates received detailed information about the study and provided written informed consent.

Data collection and analysis proceeded iteratively. We began with purposive sampling and subsequently employed theoretical sampling and constant comparative analysis, selecting each new participant based on insights from prior interviews. After the ninth interview, content began to recur; by the 13th interview, no new codes had emerged. In qualitative research, data saturation is achieved when additional data provide little or no new information [21]. Following this principle, we determined that saturation had been reached and concluded enrollment after the 14th interview.

3. Data collection

Data were collected between January and May 2025 through one-to-one in-depth interviews. A semi-structured format was adopted to ensure interviews covered key topics while allowing participants to share their stories in their own words. Prior to each interview, the interviewer met with participants to explain study objectives, obtain informed consent, and establish rapport. Building trust and creating a comfortable atmosphere were essential for obtaining honest and rich accounts; this involves attentive listening, demonstrating genuine interest and empathy, and explaining the research purpose without judgment.

Most participants were interviewed once; follow-up interviews were conducted when clarification or elaboration was needed. Interviews lasted 30–50 minutes and were conducted at the participants’ current location of care. For patients in the intensive care unit, interviews were conducted at the bedside with careful attention to safety and patient stability. For patients who had been transferred to general wards, interviews were conducted at locations preferred by the participant, such as at the bedside, in lounge areas, or in private conference rooms. One participant (Participant 3) who had been discharged was interviewed in a conference room adjacent to the stroke intensive care unit during their outpatient follow-up visit, as requested by the participant. All interview locations were chosen to ensure privacy and comfort.

The semi-structured interview guide began with broad, open-ended questions such as “Can you describe what it was like when you first lost your speech?” and “What challenges are you experiencing now?” or “What challenges did you experience when you were in the hospital because of aphasia?” for the discharged patients. The interview then explored more specific aspects, including difficulties in daily activities, support systems, and perceived improvements. The interviewer employed follow-up questions and probes tailored to participants’ responses while maintaining a neutral stance to encourage unrestricted disclosure (Figure 1).

When verbal communication was challenging, participants were encouraged to use writing or gestures; family members’ statements were considered supplementary information, depending on the participant’s communication ability. During each interview, the interviewer documented brief field notes to capture non-verbal cues such as facial expressions, body language, mood, and the overall environment.

Interviews were audio-recorded using two digital recorders with participants’ permission. Recorded content was transcribed verbatim using an artificial intelligence transcription program, ClovaNote (Naver). Transcripts were verified against the recordings to ensure accuracy, and field notes were used to contextualize the data during analysis.

4. Data analysis

Data were analyzed using inductive qualitative content analysis, following the approach described by Graneheim and Lundman [17]. Initially, two researchers read and reread each verbatim transcript to grasp the overall narrative, then divided the text into meaning units—words, phrases, or sentences that reflected participants’ experiences of aphasia. These meaning units were condensed to shorten the text while preserving core meaning and labeled with codes. Codes with similar content were grouped into subcategories, which were further clustered into broader categories based on shared characteristics. Finally, we constructed overarching themes that conveyed the potential meaning of the categories.

Qualitative content analysis is inherently iterative and reflexive [18]; therefore, researchers continually revisited transcripts, meaning units, codes, and categories, refining them as new data were collected. Each interview was analyzed within 1 week of completion so that emerging insights could inform subsequent interviews. Preliminary categories and themes were presented to three nurses with more than 5 years of experience in stroke intensive care to obtain peer feedback, which helped verify that findings resonated with clinical experience.

5. Rigor

To ensure the trustworthiness of our qualitative findings, we applied the criteria of credibility, dependability, and transferability as articulated by Lincoln and Guba [22] and elaborated by Graneheim and Lundman [17].

Credibility was addressed through purposive sampling that captured variation in demographic characteristics and aphasia subtypes, alignment of recruitment with the study aim, and continuation of interviews until no new information emerged. Member checking was conducted by inviting one participant (Participant 1) to review the derived categories and themes, which strengthens credibility and confirmability by ensuring that interpretations resonate with participants’ experiences. We also conducted a meeting with three stroke intensive care nurses to compare emergent categories with clinical practice.

Dependability was achieved by having all interviews conducted by the same researcher using a common semi-structured guide, and through iterative analysis whereby insights from earlier interviews informed subsequent data collection and coding. Throughout the study, we maintained an audit trail that recorded methodological decisions, analytical steps, and team discussions.

Transferability was enhanced by providing thick description of the research context, participant characteristics, data collection procedures, and analytical processes. We explicitly linked categories to illustrative quotations, enabling readers to judge the relevance of our findings to their own settings.

6. Researcher background and qualifications

One author has conducted and published multiple qualitative studies, providing methodological expertise. The other author, who conducted the interviews, has over 10 years of clinical experience in a stroke intensive care unit, including caring for patients with aphasia and conducting stroke research. Prior to data collection, the interviewer completed formal qualitative research training, practiced with rehearsal interviews, reviewed recordings, and consulted experienced colleagues to improve interviewing and analytical skills.

7. Ethical considerations

This study was conducted following approval from the Dong-A University Hospital Institutional Review Board (approval number: DAUHIRB-24-211). All participants provided written informed consent and were informed of their right to withdraw from the study at any time without penalty. All data are stored securely and will be destroyed 3 years after study completion.

Results

1. Participant characteristics

A total of 14 patients with acute stroke participated in the study. Participants ranged in age from 35 to 81 years, with eight being men. The most common etiology was left middle cerebral artery infarction (n=10). Aphasia types included motor aphasia (n=7), global aphasia (n=5), and sensory aphasia (n=2). At the time of interviews, 10 participants continued to experience residual language deficits, including dysarthria (Table 1).

2. Content analysis findings

Analysis of interview transcripts yielded 42 codes derived from a total of 371 meaning units, which were synthesized into 13 subcategories and subsequently clustered into five main categories. Participants’ loss of the ability to speak and understand was captured in the category “suddenly trapped in silence,” which was closely linked to “emotional impact.” Negative interactions caused by communication barriers were represented as “communication crisis,” while healthcare staff's supportive and empathetic care was categorized as “patient-centered interaction.” As language abilities gradually returned, participants experienced “emerging hope.” These five categories were ultimately integrated into the overarching theme “communication beyond language” (Table 2, Figure 2).

1) Category 1: Suddenly trapped in silence

The category “suddenly trapped in silence” vividly captures participants’ experiences of abrupt language function loss following stroke onset. This category comprises two subcategories: “words stuck in the mouth,” reflecting the struggle to articulate words despite the intention to speak, and “loss of meaning in language,” denoting the inability to convey or comprehend meaning through language.

(1) Words stuck in the mouth

Participants described profound difficulty expressing what they intended to say, despite having clear awareness of the words they wished to produce. At times, speech was abruptly blocked, leaving words “stuck” and unable to flow, while in other instances, unintended sounds emerged without volitional control. These symptoms appeared suddenly at stroke onset, and some participants also reported unusual sensations around their lips.

(2) Loss of meaning in language

Several participants described sudden inability to comprehend spoken language, perceiving others’ speech as incomprehensible sounds or as if the speaker’s mouth was moving silently. They also reported difficulty understanding their own utterances and struggled to recognize or read written letters.

2) Category 2: Emotional impact

The abrupt loss of language function evoked profound negative emotions among participants. Their accounts were clustered into two subcategories: “psychological shock” and “feeling lost.” Collectively, these experiences illustrate the overwhelming emotional impact of aphasia following stroke.

(1) Psychological shock

The sudden inability to speak brought participants an overwhelming sense of shock, confusion, and fear. Several described experiencing despair at the moment they realized they had lost the language essential for daily life, with some perceiving it as the end of their existence.

(2) Feeling lost

Many participants reported that, beyond the immediate frustration of being unable to speak, their greatest concerns centered on economic survival and the ability to support their families. These real-life pressures often overshadowed the pain of aphasia itself, compounding their sense of despair. The feeling of being lost and uncertain was particularly intense among younger and socially active participants.

3) Category 3: Communication crisis

The diverse communication difficulties that participants encountered following aphasia onset were consolidated into the category “communication crisis.” This category comprises three subcategories: “difficulties in expression,” “exclusion from decision-making,” and “reluctance and withdrawal.” Collectively, these findings highlight the multifaceted communication challenges participants faced with healthcare professionals during acute hospitalization.

(1) Difficulties in expression

In the early stages, participants were unable to communicate even their most basic physiological needs to nursing staff. They struggled to engage in simple conversations, and some also had difficulty understanding others, often becoming trapped in their own thoughts, which led to frequent misunderstandings. Several participants described experiencing extreme frustration throughout the communication process.

(2) Exclusion from decision-making

Several participants reported being excluded from conversations and treatment decisions due to their inability to speak. They felt humiliated and uncomfortable when medical staff treated them as if they were incapable of understanding, or when decisions were made solely in consultation with family members. Despite their impaired speech, participants emphasized that they retained the capacity to think and feel.

(3) Reluctance and withdrawal

Repeated communication failures caused participants to become increasingly hesitant to engage in interactions. Many feared that their incomplete speech would inconvenience or frustrate others, and even attempts at conversation with medical staff often felt uncomfortable or irritating. Some participants expressed embarrassment about their impaired speech, which led them to avoid communication altogether.

4) Category 4: Patient-centered interaction

This category highlights the efforts of healthcare professionals to maintain meaningful communication with patients despite language limitations. Participants described helpful approaches that included “supportive communication,” “empathic care,” and “active engagement.” Collectively, these strategies demonstrate how medical staff sought to preserve patients’ dignity and foster therapeutic relationships, even in the face of aphasia-related challenges.

(1) Supportive communication

Participants emphasized that when medical staff listened attentively and waited without rushing, they felt psychological stability. This supportive attitude encouraged them to attempt communication at their own pace, even if speech was slow or fragmented.

(2) Empathic care

Participants expressed gratitude for medical staff's proactive efforts to assess their needs and provide assistance without being asked. Such attentiveness offered reassurance, as if someone understood them despite the language barrier. This consideration not only alleviated the burden of communication but also provided significant psychological comfort. They emphasized that positive messages regarding the possibility of recovery served as their greatest source of strength throughout treatment.

(3) Active engagement

Participants highlighted the importance of medical staff actively engaging with them to overcome communication barriers. The willingness of staff to approach, ask questions, and persistently seek ways to facilitate understanding was perceived as powerful support. Such efforts not only promoted communication but also fostered trust and reassurance.

5) Category 5: Emerging hope

The gradual restoration of language function brought about emotional changes that fostered hope, which were integrated into the category “emerging hope.” This category encompassed three subcategories: “gradual but inconsistent recovery,” “self-directed efforts,” “anticipation of recovery.” Together, these subcategories illustrate how participants’ experiences of language improvement instilled optimism and strengthened their determination to persevere in the recovery process.

(1) Gradual but inconsistent recovery

Participants described early signs of improvement when words unexpectedly emerged or when they were able to comprehend others’ speech. They described their language recovery as inconsistent and unpredictable. At times, speech flowed smoothly with clear pronunciation, only to stop abruptly without reason. The pace of recovery varied not only across different words but also across different aspects of language function. Although participants expressed frustration with imprecise speech and inaccurate pronunciation, they acknowledged that their language abilities were gradually improving.

(2) Self-directed efforts

Despite severe language limitations, participants actively sought ways to communicate through gestures and writing. They also engaged in self-directed practices such as speaking exercises, reading, and note-taking. Through these repeated efforts, they reported experiencing gradual improvements in their language abilities.

(3) Anticipation of recovery

As their speech gradually returned, participants experienced relief and expressed optimism about continued improvement. Although their speech remained incomplete, they articulated hope and confidence in the possibility of further recovery.

Discussion

To explore the experiences of aphasia among patients with acute stroke during hospitalization, we conducted in-depth one-on-one interviews with 14 participants. Through qualitative content analysis, five categories emerged, encompassing the sudden loss of language, its psychological and emotional consequences, communication challenges, supportive patient-centered interactions, and the recovery process. Together, these categories were integrated into the overarching theme “communication beyond language,” illustrating how patients with acute aphasia sought and experienced meaningful interaction despite language limitations.

The first category, “suddenly trapped in silence,” vividly illustrates the abrupt loss of language function, in which familiar words suddenly become unspoken or incomprehensible. Previous studies have described the aphasia experience as “living in a foreign country” [23] or “I am not mad, I am not deaf” [13]. Compared with these earlier accounts, the subcategories and codes identified in our study capture more specific and realistic aspects of language loss, particularly the disruption of both motor and sensory functions of speech. The phenomenon reported by participants—clearly formulating words internally but being unable to vocalize them—represents a novel and often disconcerting experience for both patients and their caregivers [24]. This study highlighted that the onset of acute aphasia is abrupt and unpredictable, leaving patients and their families little time to recognize or come to terms with the condition. Nurses caring for patients with aphasia should therefore provide practical information about these symptoms and respond with empathy to help reduce confusion and anxiety among patients and their families.

The second category, “emotional impact,” reflects the profound psychological and emotional consequences of sudden language loss. Previous studies have emphasized the importance of early intervention, noting that emotional turmoil in the initial stages of aphasia can hinder recovery and exacerbate social isolation. Moss et al. [25] suggested that achieving emotional stability should be considered a top priority in the treatment and recovery of patients with aphasia. Similarly, Kao and Chan [26], in a large-scale cohort study, found that patients with aphasia had a 1.73-fold higher risk of developing depression within 1 year after stroke, warning that early psychological shock may progress to chronic depression. Nevertheless, in clinical practice, acute stroke management often overshadows attention to patients’ psychosocial concerns. This challenge is compounded in patients with aphasia, who face significant barriers to expressing their emotions, making it difficult for clinicians to accurately assess their psychological state. To address this gap, Baker et al. [27] emphasized the importance of early identification of emotional states using mood screening tools, and Murphy et al. [28] reported that the Stroke Aphasia Anxiety and Mood Screen is an effective instrument for detecting anxiety and depression even in the presence of language limitations.

The third category, “communication crisis,” captures the restricted communication experienced by patients during acute hospitalization that results from language loss, a difficulty most evident in interactions with medical staff. Similar findings have been reported in previous studies. Anemaat et al. [29] noted that the majority of negative experiences among patients with aphasia arise from hospital-based communication with healthcare providers. Carragher et al. [13] further emphasized that when medical staff focus exclusively on physical problems or lack appropriate communication skills, patients’ feelings of being misunderstood and alienated are exacerbated. A qualitative study also reported that while nurses acknowledged the importance of communication with patients with aphasia, they often encountered practical barriers that hindered effective interaction. In turn, these challenges left nurses with feelings of guilt and underscored the need for systematic training to improve communication [16]. Consequently, practical guidelines and educational programs for interacting with patients with acute aphasia are essential, along with environmental and institutional support within hospitals [11,30]. Such institutional support may include provision of audiovisual materials and augmentative and alternative communication tools, access to quiet consultation spaces, and multidisciplinary, team-based communication systems [30].

The fourth category, “patient-centered interaction,” reflects the positive attitudes and behaviors of healthcare professionals as experienced by patients despite profound language limitations. Prior studies have demonstrated that even among patients with severe communication difficulties, therapeutic relationships can be cultivated through authentic and respectful communication, which significantly influences the overall treatment process [31]. Patients are more likely to actively participate in communication when they feel equally respected; conversely, when medical staff adopt a task-oriented approach, communication remains constrained, even with the use of augmentative and alternative communication tools [14]. In contrast, strategies such as maintaining a calm tone of voice, establishing eye contact, employing appropriate humor, and demonstrating respect have been shown to facilitate meaningful exchanges [32]. These findings suggest that patient-centered interactions rely less on specific communication techniques and more on healthcare providers’ attitudes and patients’ perception of being valued. As the closest caregivers to patients, nurses play a pivotal role in fostering communication and trust through person-centered approaches [33].

The final category, “emerging hope,” illustrates how patients with acute aphasia gradually regained emotional optimism as their language abilities began to recover. Language functions often improve within weeks of stroke onset, with expressive abilities typically recovering more quickly than comprehension [10]. Consistent with this pattern, participants reported faster recovery of specific words and speech production than of language comprehension. Nevertheless, the recovery process was described as erratic, fluctuating, and often incomplete. Post-stroke aphasia can persist into the chronic stage and present in diverse ways depending on lesion location and rehabilitation intensity [34]. These findings indicate that recovery from aphasia is shaped not only by the natural course of neurological healing but also by patient motivation and sustained effort. Accordingly, nurses should work collaboratively with patients to recognize and reinforce signs of recovery, providing encouragement that helps patients sustain hope throughout the rehabilitation process.

The 2025 European Stroke Society guidelines recommend expanding the goals of aphasia rehabilitation beyond language restoration to encompass everyday communication, social participation, and enhanced quality of life. They further propose a range of strategies, including high-intensity individualized speech therapy, integration of digital tools, and group-based interventions [35]. Additionally, innovative approaches are emerging, such as simulation-based nurse training programs designed to strengthen patient advocacy and enhance emotional empathy [36]; Aphasia-GPT, an artificial intelligence-driven program that supports language expression by reflecting patients’ intentions and context [37]; and digital platforms enabling home-based language self-training [38]. Within this context, nurses caring for patients with aphasia can apply the person-centered communication strategies identified in this study to support practical communication and optimize the impact of these cutting-edge interventions.

This study provides an in-depth exploration of the experiences of acute stroke patients with aphasia during their hospitalization. Its primary contribution lies in capturing the distinctive features of the acute phase—abrupt language loss, profound confusion, and the complex interplay between urgent medical decisions and communication barriers. While previous research has largely focused on post-stroke aphasia, few studies have examined the acute phase, when patients experience the most severe communication crises amid intensive treatment and critical decision-making.

The findings advance both theoretical understanding and clinical practice. First, by illuminating patients’ perspectives during the acute phase, this study reveals that aphasia extends beyond a linguistic impairment to encompass deep emotional and psychosocial challenges requiring holistic care. Second, the themes and categories identified provide an empirical foundation for developing person-centered nursing interventions tailored to the acute stage. Third, these insights inform clinical education by highlighting the need to equip healthcare professionals to address the multifaceted difficulties faced by patients with acute aphasia.

For nursing practice, the results underscore the importance of early psychological assessment, empathetic communication, and active patient engagement in decision-making. Nurses should provide timely information about aphasia, recognize early signs of recovery, and foster hope while supporting patients’ autonomy throughout the recovery process.

This study has several limitations. First, stroke patients often experience multiple physical symptoms, including hemiplegia, in addition to language impairment. These comorbidities may have influenced participants’ descriptions of their aphasia experience. Although the authors carefully examined participants’ accounts to distinguish language-specific experiences, the potential influence of physical impairments cannot be completely excluded. Second, due to the nature of aphasia, some participants continued to face communication challenges; although repeated confirmation and nonverbal strategies were employed to supplement interviews, not all experiences may have been fully conveyed. Third, data beyond the scope of the interview guide—such as patients’ experiences with family members—may not have been comprehensively captured. Fourth, this study was conducted at a single institution in Korea, which may limit the transferability of findings to other healthcare settings or cultural contexts. Future research should therefore incorporate family interviews to provide a more holistic understanding of patients’ experiences with aphasia and include multi-site studies to enhance generalizability.

Conclusion

This qualitative study explored the experiences of 14 patients with acute stroke-related aphasia through in-depth interviews. Qualitative content analysis revealed the overarching theme of “communication beyond language,” encompassing five interconnected categories that illuminate the complex journey from language loss to emerging hope. Participants described the profound emotional shock of suddenly losing language function, which included difficulties in speaking and understanding speech. They experienced significant communication challenges, exclusion from decision-making processes, and, at times, withdrawal from social interactions. However, person-centered interactions with healthcare professionals—characterized by supportive, respectful, and encouraging approaches—played a crucial role in helping participants maintain hope and motivation for recovery. Based on these findings, we recommend that nurses integrate consideration of the emotional and psychosocial dimensions of aphasia into communication interventions in clinical practice. The development and implementation of comprehensive nursing education and systematic training programs are essential to strengthen person-centered communication skills and improve care for patients with acute aphasia.

Article Information

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Acknowledgements

None.

Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by Korea government (MSIT) (NRF-2022R1A2C1011917). The funding source had no role in the study design, analysis, data interpretation, or decision to submit for publication.

Data Sharing Statement

Please contact the corresponding author for data availability.

Author Contributions

Conceptualization or/and Methodology: JK, HH. Data curation or/and Analysis: JK, HH. Funding acquisition: JK. Investigation: HH. Project administration or/and Supervision: JK. Resources or/and Software: JK, HH. Validation: JK, HH. Visualization: JK, HH. Writing: original draft or/and Review & Editing: JK, HH. Final approval of the manuscript: all authors.

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