Journal of Korean Academy of Nursing

Effects of a practitioner-led empowerment program for low-income social service recipients in South Korea: a quasi-experimental study: Myung Sun Hyun, Eunyoung Park, Hyuncheol Kang, Mi-hye Kim; Received February 3, 2026 Accepted April 29, 2026 Published online May 26, 2026; DOI: https://doi.org/10.4040/jkan.26015 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to evaluate the effects of a practitioner-led empowerment program on self-sufficiency motivation, self-esteem, and self-efficacy among low-income service recipients at self-sufficiency centers.
Methods
A quasi-experimental repeated-measures design was used. Participants were recipients of social services from 11 local self-sufficiency centers in Gyeonggi-do, South Korea. In total, 100 participants were recruited, with 51 assigned to the experimental group and 49 assigned to the control group. The experimental group received an eight-session program delivered by center practitioners who had been trained by mental health nurses, whereas the control group received usual services. Self-sufficiency motivation, self-esteem, and self-efficacy were assessed at three time points: baseline (pretest: T0), immediately after the intervention (post-test: T1), and 4 weeks after the intervention (follow-up: T2).
Results
Using generalized estimating equations, participants in the experimental group showed significantly greater improvements than those in the control group at both T1 and T2 in self-sufficiency motivation (T1: B=1.61, p=.030; T2: B=2.88, p<.001), self-esteem (T1: B=2.77, p<.001; T2: B=2.78, p<.001), and self-efficacy (T1: B=3.95, p=.004; T2: B=4.19, p<.001).
Conclusion
The practitioner-led program is associated with significant short-term improvements in psychosocial determinants of self-sufficiency among low-income service recipients. These findings may inform the development of community nursing interventions that support the psychosocial foundations of independent living in this population and provide a basis for training programs designed to strengthen the capacity of practitioners at local self-sufficiency centers (Clinical Research Information Service of Korea registration number: KCT0010027; registration date: December 12, 2024).

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Lived experiences of correctional officers in treating drug offenders: a hermeneutic phenomenological approach: Hyun-Ok Jung; Received December 9, 2025 Accepted April 28, 2026 Published online May 26, 2026; DOI: https://doi.org/10.4040/jkan.25166 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study explored the lived experiences of correctional officers working with individuals convicted of drug offenses.
Methods
Data were collected through individual in-depth interviews and observations with 10 correctional officers who had experience working with individuals convicted of drug offenses. Data were collected from September 15 to November 2, 2025, and analyzed using van Manen’s hermeneutic phenomenological approach to identify essential themes.
Results
The themes were interpreted within four existential grounds: body, space, other, and time. The lived body was experienced as a body of blurred judgment and growing powerlessness, a body of heightened alertness and preparedness, and a body that closes itself off for self-preservation. The lived space was experienced as a space in which recovery stagnation and potential coexist, a space in which drug proliferation and interdiction collide, and a space in which correctional responsibility and avoidance conflict. The lived other was experienced as a relationship oscillating between hope and resignation and as a relationship characterized by withheld trust and sustained vigilance. The lived time was experienced as a transition from fulfillment to vigilance, a time of recognizing the power of addiction and issuing warnings, a transition from punishment to recovery, and a time of cycles and growth.
Conclusion
This study shows that working with individuals convicted of drug offenses is not merely the execution of regulation and control, but an existential practice of care in which correctional officers continually attune themselves to sensing risk, negotiating relationships, and sustaining the possibility of recovery.

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Effectiveness of mobile health interventions to improve medication adherence for patients with cardiovascular disease: a systematic review and meta-analysis: Yeoungsuk Song, Seurk Park, Yuyoung Lee, Sohye Lee; Received February 4, 2026 Accepted April 22, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.26016 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study systematically reviewed and synthesized the evidence on the effectiveness of mobile health (mHealth) interventions in improving medication adherence among patients with cardiovascular disease.
Methods
This systematic review included randomized controlled trials that evaluated the effects of mHealth interventions on medication adherence among patients with cardiovascular disease. PubMed, the Cochrane Library, CINAHL, and Embase were searched for peer-reviewed studies and grey literature published in English between January 1, 2013, and July 31, 2025. The Cochrane Risk of Bias 2 (RoB 2) tool was used to assess the risk of bias in the included studies. R software ver. 4.5.2 was used to perform the meta-analysis.
Results
Fifty-two studies were included in the systematic review, of which 20 were included in the meta-analysis. The pooled analysis demonstrated a significant improvement in medication adherence among patients with cardiovascular disease receiving mHealth interventions, with a moderate to large effect size (Hedges’ g=0.72; 95% confidence interval, 0.20–1.25; p<.001), despite substantial heterogeneity (I2=97%). However, a considerable proportion of the included studies were assessed as having a high risk of bias, which may limit the internal validity of the findings. Subgroup analyses indicated that the effects of mHealth interventions on medication adherence did not differ significantly according to intervention type, duration, or outcome measurement tools.
Conclusion
mHealth interventions appear to be effective in improving medication adherence among patients with cardiovascular disease. However, these findings should be interpreted with caution because of the high risk of bias and substantial heterogeneity among the included studies. Future research should explore the use of emerging technologies, such as artificial intelligence and virtual reality, to address medication non-adherence (PROSPERO registration number: CRD42023450502).

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Nursing management competencies among nurses in national specialized hospitals in Korea: a mixed-methods study: Jiyoung Choi, Jee-In Hwang; Received December 13, 2025 Accepted February 26, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.25175 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to examine nursing management competencies among nurses working in national specialized hospitals, to identify competency development needs and influencing factors, and to provide foundational data for the development of educational and competency-enhancement programs.
Methods
A mixed-methods design was employed. Quantitative data were collected via an online survey of 162 nurses from five national specialized hospitals from January 10 to February 10, 2025, and qualitative data were obtained through in-depth interviews with 20 participants from March 7 to April 16, 2025. Quantitative data were analyzed using descriptive statistics, independent t-tests, analysis of variance, importance–performance analysis, the Borich Needs Assessment, the Locus for Focus model, and multiple regression analysis. Qualitative data were analyzed using content analysis with ATLAS.ti.
Results
The mean performance score for nursing management competencies was 3.56±0.71 on a 5-point scale. Customer orientation received the highest score (4.03±0.78), whereas business and marketing received the lowest score (2.92±1.03). Across needs-assessment models, leadership, nursing ethics and law, quality improvement, and standard development consistently emerged as high-priority areas. In multiple regression analysis, the nursing work environment was the only factor significantly associated with nursing management competency performance (β=.33, p<.001). Qualitative content analysis corroborated these findings and identified three facilitator themes and three barrier themes.
Conclusion
Nursing management competency performance among nurses in national specialized hospitals was associated with the nursing work environment, including organizational conditions. These findings underscore the importance of organizational support and suggest that competency-based education should be redesigned to prioritize high-need competency areas. This study provides a foundation for developing educational interventions and programs to enhance nursing management capacity.

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Development and evaluation of a health education program to enhance middle school students’ climate adaptation competencies: a nonequivalent control group pretest–posttest study in Korea: Jiyu Hyun, Ju Hee Kim; Received October 13, 2025 Accepted February 7, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.25139 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop and evaluate the Climate and Health Action Mitigation Program (CHAMP), a health education intervention designed to enhance middle school students’ competencies for practicing climate adaptation behaviors in response to the health impacts of climate change.
Methods
A quasi-experimental pretest-posttest nonequivalent control group design was employed. Data were collected from October to December 2024. A total of 3rd-year middle school students; 9th grade equivalent, aged 14-15 students were assigned to either an experimental group that received the CHAMP intervention or a control group that received conventional health education. The CHAMP curriculum comprised six sessions developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design model and was aligned with the 2022 revised national health curriculum and the instructional hours stipulated in the School Health Act. Climate adaptation competency and its seven subdomains—climate-change knowledge, climate sensitivity, reflective thinking, integrative thinking, communication skills, decision-making ability, and willingness to act—were assessed before and after the intervention.
Results
Compared with the control group, the experimental group demonstrated statistically significant improvements (p<.01) in overall climate adaptation competency as well as in all seven subdomains. The largest improvements were observed in willingness to act, climate sensitivity, and climate-change knowledge. The CHAMP intervention was associated with meaningful improvements in students’ climate adaptation competencies, encompassing cognitive, behavioral, and attitudinal domains.
Conclusion
These findings support the feasibility and educational value of integrating climate–health content into the national curriculum. Future research should examine the scalability of CHAMP and evaluate its long-term sustainability and effects across diverse educational settings.

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A structural equation model of respiratory infection prevention behaviors among elementary school teachers in South Korea: a cross-sectional study: Yoon-Ji Lee, JONG-EUN LEE; Received January 22, 2026 Accepted April 29, 2026 Published online May 21, 2026; DOI: https://doi.org/10.4040/jkan.26010 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop and test a structural equation model of respiratory infection prevention behaviors among elementary school teachers based on the Information–Motivation–Behavioral Skills model.
Methods
This study included 250 teachers who were currently working in elementary schools and had experience as homeroom teachers. Data were collected from December 18 to December 31, 2023 using self-reported questionnaires. The proposed model included school organizational culture as the exogenous variable and respiratory infection prevention knowledge, respiratory infection prevention attitude, social support, self-efficacy, and respiratory infection prevention behavior as endogenous variables. Data were analyzed using IBM SPSS for Windows ver. 24.0 and Smart PLS ver. 4.1.
Results
Of the 19 hypothesized paths in the research model, five were statistically significant. School organizational culture had a significant direct effect on respiratory infection prevention knowledge (β=.20, p=.041), social support had a significant direct effect on self-efficacy (β=.33, p=.001), and self-efficacy had a significant direct effect on respiratory infection prevention behaviors (β=.22, p=.021). Respiratory infection prevention attitude (direct: β=.23, p=.029; total: β=.26, p=.008) and school organizational culture (direct: β=.22, p=.017; total: β=.30, p=.002) had significant direct and total effects on respiratory infection prevention behaviors.
Conclusion
To enhance respiratory infection prevention behaviors among elementary school teachers, interventions should focus on strengthening positive attitudes toward infection prevention and improving self-efficacy. Organizational-level strategies, including establishing supportive school organizational cultures, promoting peer support among teachers, and sharing infection prevention practices within schools, are also needed to facilitate and sustain preventive behaviors.

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Development of emergency nursing educational materials in Lao People's Democratic Republic: a methodological study: Jina Oh, Eunsil Won, Seohyun Won, Sunmi Kim, Seryung Oh, Souksavanh Phanpaseuth, Anousone Sisoulath, Lamngeun Silavong; Received December 12, 2025 Accepted April 28, 2026 Published online May 21, 2026; DOI: https://doi.org/10.4040/jkan.25174 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop contextualized emergency nursing educational materials tailored to the Lao People’s Democratic Republic (Lao PDR). Emergency nurses in Lao PDR face challenges arising from the lack of standardized, culturally relevant learning resources. Existing materials are often adopted from other countries and do not adequately reflect local needs, contributing to inconsistencies in clinical practice. Developing locally tailored resources, supported by official development assistance, is therefore essential for improving emergency nursing education and practice.
Methods
This study used a methodological design based on the Four-Door Model—Define, Design, Develop, and Disseminate—from 2021 to 2024. A situational analysis was conducted using a mixed-methods approach that included a quantitative survey of 70 nursing professionals and qualitative interviews with 52 stakeholders. Content validity and suitability were evaluated by a panel of six local experts using standardized validation forms and the Suitability Assessment of Materials (SAM).
Results
Ten emergency nursing domains were developed to address both universal principles, including triage protocols and life support interventions, and Lao PDR-specific challenges. Validity and suitability were supported by a SAM score of 77.3%, indicating clinical accuracy and cultural appropriateness. The 269-page coursebook was distributed to partner nursing colleges, three central hospitals, and international organizations.
Conclusion
This study developed the first comprehensive emergency nursing educational materials tailored to the Lao PDR context and written in the local language. These materials support continuing professional development and license renewal every 5 years. They also exemplify an international development paradigm that prioritizes recipient-country ownership and sustainable capacity building through collaborative knowledge creation.

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Migrant health research in South Korea, 2010–2021: a scoping review: Soo Jin Kang, Bok-Nam Seo; Received November 10, 2025 Accepted March 16, 2026 Published online May 19, 2026; DOI: https://doi.org/10.4040/jkan.25152 [Epub ahead of print]

Abstract PDF ePub: Purpose
This scoping review mapped research trends in migrant health in Korea and evaluated their alignment with global priorities.
Methods
We conducted a scoping review using the Arksey and O’Malley framework. We searched PubMed, CINAHL, Scopus, KoreaMed, ScienceON, RISS, and KISS for articles published between 2010 and 2021, which defined the review period. The inclusion criteria were studies of adult migrants residing in Korea, primary empirical research, and academic journal articles with full text available in Korean or English. Two reviewers performed inductive coding and assigned each study to one primary subject area for frequency counts.
Results
Of 1,669 records, 273 studies met the inclusion criteria. Marriage-migrant women were the most frequently studied group (56.4%), followed by migrant workers (20.5%) and international students (7.0%). Ten subject areas were identified. Mental health (56/273; 20.5%) and health status and quality of life (47/273; 17.2%) were the most common, whereas infection was the least common (6/273; 2.2%). According to World Health Organization priority areas, P4 (tackling the social determinants of health) was the most common (132/273; 48.4%), followed by P1 (promoting health through public health interventions) (73/273; 26.7%). P3 (mainstreaming health policies and fostering partnerships) and P5 (strengthening health monitoring and information systems) were minimally represented (6/273; 2.2% and 11/273; 4.0%, respectively).
Conclusion
Migrant health research in Korea is heavily concentrated on individual-level topics and marriage-migrant populations, with limited evidence on policies, monitoring systems, and underserved groups (e.g., refugees and diverse populations). Future studies should diversify the populations examined, standardize national monitoring and linked data infrastructure, strengthen the P3 and P5 priority areas, and include more longitudinal, interventional, and policy evaluation research.

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Nurse retention discourse in YouTube comments: a structural topic modeling analysis: Taewha Lee, JooHyun Lee; Received December 11, 2025 Accepted March 10, 2026 Published online May 18, 2026; DOI: https://doi.org/10.4040/jkan.25172 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study analyzed public discourse on nurse retention through YouTube comments posted between 2018 and 2024 to examine how retention issues are collectively framed in online public spheres, thereby extending individual-level retention research to societal-level discourse analysis.
Methods
Comments were collected from 226 YouTube videos uploaded between January 2015 and December 2024, identified using search terms that combined “nurse” with retention-related keywords. After duplicates and comments posted outside the study period were removed, 32,399 comments were analyzed using structural topic modeling with year and number of likes as covariates. Topic correlation network analysis with community detection was used to identify discourse coalitions.
Results
Fourteen substantive topics and one noninterpretive topic emerged, spanning individual coping strategies, organizational workplace issues, and systemic policy structures. “International nursing migration and career pathways” (12.8%) and “Disputes regarding the scope of practice among professionals” (11.4%) were the most prevalent topics. Temporal analysis revealed discourse shifts consistent with focusing events theory: COVID-19 (coronavirus disease 2019) activated structural critique frames while suppressing career mobility discourse; the 2022 Nursing Law followed an issue-attention cycle pattern; and the 2024 medical school quota expansion embedded retention discourse within broader healthcare policy debates. Network analysis identified two discourse communities, professional identity and structural exploitation, with international migration serving as a bridging frame across both.
Conclusion
Public discourse framed nurse retention as a systemic and structural issue rather than as an expression of individual professional rejection. These collective framing patterns complement traditional survey-based research and may inform policy design by identifying which frames achieve public resonance and where discourse fragmentation may challenge policy implementation.

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Experiences of nurses working as physician assistants under the expanded scope-of-practice policy following the 2024 resignation of medical residents in South Korea: a phenomenological study: Tae Yeong Yang, Myung Jin Jang, NaHyun Lee; Received January 12, 2026 Accepted April 25, 2026 Published online May 14, 2026; DOI: https://doi.org/10.4040/jkan.26001 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to explore the lived experiences of clinical support nurses under the expanded scope-of-practice policy implemented after the mass resignation of medical residents in Korea in 2024. In Korea, these nurses are often referred to as physician assistant (PA) nurses, although they differ from licensed physician assistants or nurse practitioners in the United States. The study sought to understand how the policy was perceived, implemented, and interpreted by nurses who played a key role in maintaining clinical services during a healthcare workforce crisis.
Methods
A qualitative phenomenological design based on Colaizzi’s method was used. Fourteen clinical support nurses from a tertiary hospital in Seoul participated in in-depth, semi-structured interviews conducted between August and December 2025. The interviews were transcribed verbatim and analyzed through iterative reading, extraction of significant statements, formulation of meanings, and thematic integration. Trustworthiness was established using the criteria of credibility, dependability, transferability, and confirmability.
Results
Four essential themes were identified: (1) multifaceted perceptions of the 98-item expanded scope-of-practice policy; (2) gaps in the current education system and demands for structured training; (3) ambivalent experiences during policy implementation; and (4) conditional acceptance of the policy’s sustainability and calls for improvement. Participants reported increased professional recognition and autonomy while also experiencing ambiguity in role boundaries, concerns about legal accountability, and emotional burden related to insufficient preparation and protection.
Conclusion
The expanded scope-of-practice policy both strengthens professional competence and creates role instability among clinical support nurses. Its sustainable implementation requires clear legal protection, standardized education and certification systems, appropriate compensation, and the active involvement of frontline nurses in policy development.

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The mediating effects of perceived organizational support and coping strategies on the relationship between job stress and professional quality of life among nurse managers in tertiary and general hospitals: Seo-In Yang, Min-Jung Choi; Received July 17, 2025 Accepted January 21, 2026 Published online April 6, 2026; DOI: https://doi.org/10.4040/jkan.25099 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to examine the mediating effects of perceived organizational support and coping strategies on the relationship between job stress and professional quality of life among nurse managers working in tertiary and general hospitals.
Methods
The participants were 299 nurse managers employed at tertiary and general hospitals located in Seoul and Gyeonggi Province. Data on job stress, perceived organizational support, coping strategies, and professional quality of life were collected using an online self-report questionnaire between June 28, 2024, and May 31, 2025. The collected data were analyzed using IBM SPSS Statistics ver. 27.0 and the PROCESS Macro ver. 4.0.
Results
Job stress was identified as a significant predictor of professional quality of life among nurse managers. Perceived organizational support and active coping demonstrated significant mediating effects on compassion satisfaction. Active coping showed a significant mediating effect on burnout, whereas perceived organizational support mediated secondary traumatic stress. Passive coping did not demonstrate a significant mediating effect on any of the three subdomains of professional quality of life.
Conclusion
Job stress is closely associated with compassion satisfaction, and this relationship is partially mediated by perceived organizational support and active coping. Accordingly, targeted interventions are required to reduce job stress, strengthen organizational support, and enhance coping competencies among nurse managers. Furthermore, reinforcing institutional- and policy-level support is essential to mitigate secondary traumatic stress and to ensure the sustainability of nurse managers’ professional roles.

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

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

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

Abstract PDF ePub: Purpose
This study investigated the perspectives of parents, teachers, and community leaders regarding adolescents’ sexual behavior in Cambodia.
Methods
Grounded in the ‘ecological framework of adolescent health,’ this study employed a descriptive qualitative approach to explore the perspectives of key stakeholders, including 12 parents, eight teachers, and four community leaders. Drawing on in-depth, semi-structured individual and focus group interviews, the study examined risk and protective factors related to risky sexual behavior across family, school, community, social, cultural, and policy contexts. Data collection was conducted from December 5, 2022 to January 31, 2023.
Results
The integrated thematic analysis revealed six main themes. Parents positioned themselves as anxious protectors but struggled with limited opportunities for open conversation; teachers acted as observe-and-warn mediators, constrained by institutional authority, curricular boundaries, and rapidly shifting youth culture; and community leaders interpreted emerging trends through the lens of social change, eroding traditions, and weakening collective governance. Across groups, participants acknowledged the limitations of unilateral action and advocated for multilevel, collaborative solutions that bridge families, schools, and broader communities.
Conclusion
The study concluded that adolescent sexual behaviors should be understood from diverse perspectives. This finding highlights the need for culturally appropriate and sensitive measures supported by multisectoral systems operating at the family, school, community, civil society (e.g., non-governmental organizations), and national levels.

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

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

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

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

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

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

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

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

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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; Correction in: https://doi.org/

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Abstract PDF ePub

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

Citations

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The Effects of Perceived Time Pressure, Presenteeism, and Patient Safety Culture of General Hospital Nurses on Patient Safety Management Activities
Young Suk Yoo, Ju Young Park
Journal of Korean Public Health Nursing.2026; 40(1): 63. CrossRef

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

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

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

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

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

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

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

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

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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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Why Self‐Leadership Alone Is Not Enough: How Professional Self‐Concept and Organizational Commitment Shape Male Nurses’ Intention to Stay
Donghyeok Lee, Mihwa Shim, Jungmin Lee, Matthew Vandermeulen
Journal of Nursing Management.2026;[Epub] CrossRef
The Effects of Nurses’ Dispatch Work Characteristics on Job Embeddedness, Organizational Commitment, and Turnover Intention
Eejee Jung, Gunjeong Lee
Journal of Korean Academy of Nursing Administration.2025; 31(5): 560. CrossRef
Nurses' Experience Working with Substitute Nurses
Hye Mi Kim, Yeon Hee Kim, Jeong Hye Kim
Journal of Korean Association for Qualitative Research.2025; 10(3): 208. CrossRef

2,731 View
298 Download
1 Web of Science
3 Crossref

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

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

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

Abstract PDF ePub

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

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Generative AI use in instructor-assigned learning activities among nursing students: A cross-sectional survey of perceptions, ethical awareness, faculty restrictions, and continuance intention
Yun-Ting Huang, Hsiao-Fang Hsiung, Hui-Ling Lin, Li-Chun Chang, Li-Ling Liao
Nurse Education Today.2026; 165: 107162. CrossRef
Nursing Students' Perspectives on the Use of Artificial Intelligence in Psychiatric Nursing Education: A Qualitative Meta-Synthesis
Sukyung Son, Eunyoung Park
Journal of Korean Academy of psychiatric and Mental Health Nursing.2025; 34(Special Is): 9. CrossRef

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

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

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

Abstract PDF ePub

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

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Impact of role conflict and job stress on turnover intention among Korean physician assistant nurses: A cross-sectional study
Jin-Won Lee, Eun-Hi Choi, Ji-Sun Back
International Journal of Nursing Sciences.2026; 13(2): 172. CrossRef

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1 Crossref

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

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

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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

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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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
Journal of Korean Academy of Nursing.2026; 56(1): 39. CrossRef

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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
Systematic review of patient-reported outcome item libraries in cancer research: an EORTC Quality of Life Group study
Rosemary Peacock, Christopher Bedding, Bonnie Pacheco, Hayat Hamzeh, Claire Piccinin, Alexandra Gilbert
JNCI: Journal of the National Cancer Institute.2026;[Epub] CrossRef

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

Abstract PDF ePub

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

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Factors Influencing Psychiatric Nursing Competency among Emergency Nurses: The Mediating Effect of Psychological Safety in a Cross-Sectional Study
Yu Jin Lee, Chung Hee Woo
Journal of Korean Academy of psychiatric and Mental Health Nursing.2026; 35(1): 53. CrossRef

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

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

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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.

4,314 View
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