Journal of Korean Academy of Nursing

Articles in E-pub version are posted online ahead of regular printed publication.

Research Papers

Concept mapping study of positive patient experiences among family members of nursing home residents in South Korea: Hyoungshim Choi, InJa Choi, Jui Kim; Received February 6, 2026 Accepted May 23, 2026 Published online July 29, 2026; DOI: https://doi.org/10.4040/jkan.26021 [Epub ahead of print]

Abstract PDF ePub: Purpose
Describing the quality of care provided to older adults in nursing homes is challenging when residents have severe cognitive decline. Evaluation within a patient-centered care framework can be strengthened by incorporating the perspectives of residents’ family members.
Methods
Data were collected from May 8, 2023, to July 18, 2023, through interviews with 19 family members of nursing home residents aged 65 years or older who had lived in the facility for at least 30 days. Interview data were used to develop empirical statements on the nature of residents’ experiences as perceived by family members. These data were then analyzed using concept mapping to identify components of positive patient experiences from the perspectives of family members of nursing home residents in Korea.
Results
Multidimensional scaling and hierarchical cluster analysis yielded 59 core statements, two dimensions, and four clusters of positive service experiences. The two dimensions were type of support (physical vs. emotional) and centrality of care (resident-centered vs. family-centered). The four clusters of positive patient experiences were “facility management focused on quality of life,” “active communication and engagement,” “respect and trust,” and “professional and personalized care.”
Conclusion
These findings provide insight into the experiences valued by family members of older adults in nursing homes. The concept map may inform development of a patient experience index tailored to family members of nursing home residents.

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Effects of a health literacy program on COVID-19 awareness and preventive behaviors among older adults in Bangkok, Thailand: a quasi-experimental study: Walaya Tupanich, Sasawan Attaworakun, Suteekarn Chaiyalap, Nattanan Wattanawikan; Received October 30, 2025 Accepted May 12, 2026 Published online July 28, 2026; DOI: https://doi.org/10.4040/jkan.25147 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study examined the effectiveness of a health literacy (HL) enhancement program in improving awareness of and preventive behaviors related to coronavirus disease 2019 (COVID-19) among older adults in an urban community in Bangkok, Thailand.
Methods
This quasi-experimental study included 76 older adults in Dusit District, Bangkok. Eight participants were lost to follow-up, leaving 68 participants for analysis (34 per group). The intervention was based on Pengjuntr’s V-shape HL model, which includes six domains: access, understanding, interactive communication, decision-making, behavior change, and advocacy. The program was delivered through group sessions, LINE-based communication, community activities, and home visits. Data were collected at baseline, post-test (4 weeks), and follow-up (12 weeks) using questionnaires. Outcomes were analyzed using linear mixed-effects models. This study was retrospectively registered with the Thai Clinical Trials Registry (TCTR20260502013).
Results
At post-test, the experimental group had significantly higher COVID-19 awareness and preventive behavior scores than the control group (p<.001). Within-group analysis showed significant improvements in preventive behavior at both post-test and follow-up, whereas awareness improved significantly at follow-up. Significant between-group differences were also observed at follow-up (p<.001), with higher scores in the experimental group.
Conclusion
The HL enhancement program improved COVID-19 awareness and preventive behaviors among older adults, and preventive behaviors demonstrated more consistent and sustained improvement. These findings support the use of nurse-led, community-based HL interventions with behavioral reinforcement to promote COVID-19 prevention among urban older adults.

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Effects of a hybrid delirium nursing competency enhancement program using the metaverse and standardized patients for intensive care unit nurses: a quasi-experimental study: Juwon Yun, Mi Yang Jeon; Received February 4, 2026 Accepted June 4, 2026 Published online July 27, 2026; DOI: https://doi.org/10.4040/jkan.26013 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study evaluated the effects of a hybrid simulation program using the metaverse and standardized patients to enhance delirium nursing competency among intensive care unit (ICU) nurses. Outcomes included delirium nursing knowledge, attitudes, and performance confidence.
Methods
A quasi-experimental study with cluster allocation was conducted among 52 ICU nurses, including 28 in the experimental group and 24 in the control group. Data were collected from July 8 to August 28, 2024. The experimental group participated in a hybrid delirium nursing competency simulation program comprising two metaverse-based sessions (lectures, quizzes, discussions, and practice) followed by a face-to-face standardized patient simulation session. The control group received a conventional face-to-face lecture on delirium nursing. Data were analyzed using the chi-square test, the Fisher exact test, the independent t-test, and the paired t-test with IBM SPSS Statistics ver. 27.0.
Results
After the intervention, the experimental group demonstrated significantly greater improvement in delirium nursing attitude (t=2.05, p=.046) and performance confidence (t=3.35, p=.002) compared with the control group. However, the change in delirium nursing knowledge did not differ significantly between groups (t=0.71, p=.483).
Conclusion
The hybrid delirium nursing competency program using the metaverse and standardized patients was associated with greater positive changes in ICU nurses’ delirium nursing attitudes and performance confidence than conventional lecture-based education. This immersive and interactive hybrid simulation approach may be a sustainable continuing education strategy for strengthening delirium nursing competency among ICU nurses.

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Latent profile analysis of health and fatigue recovery among shift work nurses and differential associations with participation in a shift work improvement pilot project: a descriptive cross-sectional study: eunhee Jung, Eunhye Kim, suryang seo, Sunyoung Lee, Sora An, Hyejin Kim, Ye seul Kim, Youjin Kim, mijeong Park, Hyoun-Joong Kong, Saram Lee, YEONG JOO HONG, Minho Jung; Received January 21, 2026 Accepted June 12, 2026 Published online July 23, 2026; DOI: https://doi.org/10.4040/jkan.26006 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to identify latent profiles of shift-work nurses according to perceived health, fatigue, and recovery levels and to examine differences across profiles in work-related outcomes, including sleep quality, work-life balance, job satisfaction, and turnover intention. It also examined whether patterns associated with participation in a shift-work improvement pilot project differed by latent profile.
Methods
This descriptive cross-sectional study included 120 shift-work nurses working in pediatric wards at a tertiary hospital in South Korea. Data were collected from January 14 to 24, 2025. Latent profile analysis was performed using the 36-Item Short Form Health Survey and the Occupational Fatigue Exhaustion Recovery Scale. Differences in outcomes by latent profile membership and pilot-project participation status at the time of data collection were examined using two-way analysis of covariance, with age included as a covariate.
Results
Three latent profiles were identified: Healthy-Recovery (20.8%), Moderate (41.7%), and Burnout-Vulnerable (37.5%). Significant differences among profiles were observed in sleep quality (F=37.37, p<.001), work-life balance (F=50.86, p<.001), job satisfaction (F=12.29, p<.001), and turnover intention (F=12.11, p<.001). A significant interaction between latent profile membership and pilot-project participation was observed for job satisfaction (F=4.77, p=.010, partial η²=.078). Pilot-project participation was associated with significantly higher job satisfaction only in the Healthy-Recovery profile (p=.005).
Conclusion
Associations between pilot-project participation and work-related outcomes differed according to nurses’ health, fatigue, and recovery profiles. These findings indicate that heterogeneity among shift-work nurses should be considered when interpreting work-related outcomes and designing tailored support strategies.

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