Journal of Korean Academy of Nursing

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; Funded: National Biobank of Korea, Agency for Disease Control and Prevention

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.

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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; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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.

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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; Funded: National Research Foundation of Korea

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.

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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; Funded: Government-wide R&D Fund for Infectious Disease Research

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.

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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; Funded: Navamindradhiraj University Research Fund

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.

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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; Funded: Korean Society of Nursing Science, Soonchunhyang University

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.

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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; Funded: Korean Society of Nursing Science, Korean Federation of Science and Technology Societies, Soonchunhyang University

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.

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Serial mediation effects of social support and antepartum depression on the relationship between fetal attachment and anxiety in high-risk pregnant couples of South Korea: Mihyeon Park, Sukhee Ahn; J Korean Acad Nurs 2025;55(1):19-33. Published online February 4, 2025; DOI: https://doi.org/10.4040/jkan.24070; Funded: National Research Foundation of Korea

Abstract PDF ePub: Purpose
This study examined the direct effects of fetal attachment, social support, and antepartum depression on anxiety in pregnant women with high-risk pregnancy-related conditions and their husbands. Furthermore, it aimed to explore the serial mediation effects of social support and antepartum depression in the relationship between fetal attachment and anxiety.
Methods
A survey-based study was conducted among pregnant women diagnosed with high-risk pregnancy conditions at 24–32 weeks and their husbands, recruited from a pregnant women’s online community between January 20, 2021 and July 20, 2022. Data were collected from 294 individuals (147 couples) using self-report questionnaires. Correlations between variables were analyzed using the IBM SPSS software ver. 26.0 (IBM Corp.), and the mediation effects were assessed using the PROCESS macro, model 6.
Results
In the maternal model, maternal-fetal attachment directly affected anxiety (p=.005), with antepartum depression partially mediating this relationship (95% confidence interval [CI], –0.26 to –0.01). In the paternal model, paternal-fetal attachment had no direct effect on anxiety (p=.458). However, social support and antepartum depression fully mediated the relationship between paternal-fetal attachment and anxiety (95% CI, –0.14 to –0.03).
Conclusion
The findings indicate that social support in the relationship between fetal attachment and depression in high-risk pregnant women and their partners can have direct or indirect effects on the negative emotions of high-risk pregnant couples. It is necessary to assess the level of anxiety in couples experiencing high-risk pregnancies and provide comprehensive nursing interventions that address fetal attachment, social support, and antepartum depression in order to reduce anxiety.

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

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

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