Journal of Korean Academy of Nursing

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.

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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.

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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.

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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.

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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.

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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.

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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

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2 Crossref

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.

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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.

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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

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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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.

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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

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

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

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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.

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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

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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.

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

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

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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.

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Formative versus reflective measurement models in nursing research: a secondary data analysis of a cross-sectional study in Korea: Eun Seo Park, Young Il Cho, Hyo Jin Kim, YeoJin Im, Dong Hee Kim; J Korean Acad Nurs 2025;55(1):107-118. Published online February 19, 2025; DOI: https://doi.org/10.4040/jkan.24095

Abstract PDF ePub: Purpose
This study aimed to empirically verify the impact of measurement model selection on research outcomes and their interpretation through an analysis of children’s emotional and social problems measured by the Pediatric Symptom Checklist (PSC) using both reflective and formative measurement models. These models were represented by covariance-based structural equation modeling (CB-SEM) and partial least squares SEM (PLS-SEM), respectively.
Methods
This secondary data analysis evaluated children’s emotional and social problems as both reflective and formative constructs. Reflective models were analyzed using CB-SEM, while formative models were assessed using PLS-SEM. Comparisons between these two approaches were based on model fit and parameter estimates.
Results
In the CB-SEM analysis, which assumed a reflective measurement model, a model was not identified due to inadequate fit indices and a Heywood case, indicating improper model specification. In contrast, the PLS-SEM analysis, assuming a formative measurement model, demonstrated adequate reliability and validity with significant path coefficients, supporting the appropriateness of the formative model for the PSC.
Conclusion
The findings indicate that the PSC is more appropriately analyzed as a formative measurement model using PLS-SEM, rather than as a reflective model using CB-SEM. This study highlights the necessity of selecting an appropriate measurement model based on the theoretical and empirical characteristics of constructs in nursing research. Future research should ensure that the nature of measurement variables is accurately reflected in the choice of statistical models to improve the validity of research outcomes.

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The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty: Kyung-Hye Park, Hee-Young Kang; J Korean Acad Nurs 2024;54(4):547-562. Published online October 22, 2024; DOI: https://doi.org/10.4040/jkan.24027

Abstract PDF Supplementary Material ePub

Purpose

This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.

Methods

This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.

Results

Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.

Conclusion

These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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Self-efficacy and implementation intentions in home rehabilitation of stroke patients: the parallel mediating role of recurrence risk perception and outcome expectations
Xiaowen Jiang, Qiuxue Sun, Rong Tang, Shuxian Liu, Xi Chen, Yumei Lv
Frontiers in Psychology.2025;[Epub] CrossRef
Factors Influencing Decision-Making and Rehabilitation Among Older Women Who Underwent Total Knee Replacement: A Qualitative Study in Taiwan
Ching Han Huang, Yun Yee Chen, Shu Wen Chen, Chen Ti Wang, Mei Hsiang Lin
Patient Preference and Adherence.2025; Volume 19: 3931. CrossRef

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Development and Effectiveness of Progressive Simulation Education Program on Medication Safety for Nursing Students: Se-Young Jung, Eun-Young Kim; J Korean Acad Nurs 2024;54(4):563-576. Published online October 14, 2024; DOI: https://doi.org/10.4040/jkan.24054

Abstract PDF ePub

Purpose

This study aimed to develop and verify a progressive simulation education program aimed at enhancing nursing students’ medication safety competency.

Methods

A non-equivalent control group pretest-posttest design was adopted. The participants were 40 third-year nursing students with no prior simulation education experience, comprising 20 each in the experimental and control groups. The experimental treatment utilized a hybrid simulation approach incorporating both full-body mannequins and standardized patients and was, conducted over three sessions with durations of 65, 80, and 95 minutes for the first, second, and third sessions, respectively, for a total of 240 minutes. The program was constructed based on Jeffries’ simulation model.

Results

The levels of medication safety competencies, communication self-efficacy, learning self-efficacy, and problem-solving abilities of the experimental group were significantly higher than that of the control group.

Conclusion

Our results confirm that the program effectively improves nursing students’ medication safety competence, communication self-efficacy, learning self-efficacy, and problem-solving ability. Therefore, this program can serve as a basis for developing educational strategies related to medication safety for nursing education institutions. Furthermore, the program is anticipated to have a positive impact on novice nurses’ education and practice in clinical settings.

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Safety-centered simulation education using the 360-degree video room of errors: A mixed-methods study
Jiyoung Kim, Yeji Kim, Hyunji Park, Jiyeong Won, Jiwon Yun, Yuran Lee
Clinical Simulation in Nursing.2026; 111: 101899. CrossRef

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Development of the Hybrid Clinical Practicum Environment Scale for Nursing Students: Seoyoung Yoon, Hye-Ah Yeom; J Korean Acad Nurs 2024;54(3):340-357. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24016

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