Purpose
Person-centered care is essential to improving patient outcomes, yet the factors that influence it require further investigation. This study examines the relationships among nurses’ compassion competence, cultural competence, intercultural communication skills, and person-centered care, and it identifies key predictors of person-centered care. Methods: A descriptive survey was conducted among 191 nurses from two general hospitals using convenience sampling between April 1 and April 22, 2024. Data collection included measures of compassion competence, cultural competence, intercultural communication skills, and person-centered care. Statistical analyses involved descriptive statistics, the independent t-test, analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression. Results: Of the 191 participants, 172 (90.1%) were females and 19 (9.9%) were males, with an average clinical experience of 8.89 years. Person-centered care showed significant positive correlations with compassion competence (r=.58, p<.001), cultural competence (r=.62, p<.001), and intercultural communication skills (r=.63, p<.001). Key predictors of person-centered care included intercultural communication skills (β=.29, p=.001), compassion competence (β=.27, p<.001), cultural competence (β=.20, p=.024), and non-shift work status (β=.12, p=.031). The model explained 47.9% of the variance in person-centered care (F=44.76, p<.001). Conclusion: In this study, person-centered care among nurses was influenced by compassion competence, cultural competence, intercultural communication skills, and work type. Further research is warranted on the delivery of person-centered care among nurses who provide care to patients from diverse cultural backgrounds.

Purpose
Colorectal cancer (CRC) survivors face significant challenges after completing treatment, including returning to work, concerns about the future, and financial difficulties. Understanding how inner strength developed after treatment affects survivors’ lives is crucial for informing patient-centered care. This study explored the unique inner strength exhibited by CRC survivors during their transition to a “new normal.” Methods: We recruited 16 patients from Korea who had completed treatment, to explore their experiences of managing their health. We conducted a qualitative study from July 4, 2022 to July 25, 2022 using individual interviews and directed content analysis. Transcribed interview data were analyzed to interpret meaning from the data, consistent with the naturalistic paradigm. Results: Participants described their transition to a new normal by reframing the cancer experience, struggling to return to normal life, experiencing growth promoted by supportive relationships, and encountering both positive and negative life changes. Throughout these experiences as survivors, inner strength played a critical role in adapting to a new normal. Conclusion: Our findings suggest that inner strength serves as a dynamic psychological resource, enabling CRC survivors to reframe their illness, regain disrupted roles, and reconstruct a meaningful life despite ongoing physical and emotional challenges. In doing so, inner strength facilitates their adaptation to a new normal.

Purpose
This study examined the effects of cognitive function, health literacy, and social support influence the risk of self-care non-adherence among older adults with chronic kidney disease. Methods: A cross-sectional survey was conducted using structured questionnaires. The study included 105 older adults (≥65 years) in the pre-dialysis stage, all of whom were receiving regular follow-up at a nephrology outpatient clinic in Jeonju, Jeollabuk-do, Korea. Data were collected through one-on-one interviews from April to May 2024 and analyzed using SPSS version 26.0. Predictive factors were assessed using hierarchical multiple regression analysis. Results: The risk of self-care non-adherence was significantly correlated with cognitive impairment (r=.61, p<.001), lower social support from healthcare providers (r=–.36, p<.001), and reduced health literacy (r=–.42, p<.001). Multiple regression analysis indicated that decreased physical activity (β=.25, p=.002), greater cognitive impairment (β=.29, p<.001), and lower support from healthcare providers (β=–.26, p=.008) were significant predictors of increased risk of self-care non-adherence. The model explained 46% of the variance in the risk of self-care non-adherence. In contrast, family support and health literacy were not significant predictors. Conclusion: To reduce the risk of self-care non-adherence in older adults with chronic kidney disease, routine cognitive screening and tailored education for those with cognitive impairment should be implemented in outpatient care. Promoting physical activity and strengthening support from healthcare providers are also key strategies to improve adherence in this population.

Purpose
This study developed a self-management program for patients undergoing lumbar spinal stenosis surgery utilizing the information-motivation-behavioral skills (IMB) model. Methods: This study employed a quasi-experimental design with a nonequivalent control group and pretest–posttest design. Data were collected from August 11, 2022, to March 31, 2023, at a general hospital in South Korea. A total of 58 patients participated in the study (30 experimental, 28 control group). The experimental group received a six-session self-management program based on the IBM model, whereas the control group received usual education and information. Data were analyzed with SPSS/WIN 23.0 using the independent t-test, chi-square test, Fisher’s exact test, Shapiro-Wilk test, and Mann-Whitney U test. Results: Significant differences were observed in self-management information (p<.001), personal motivation (p=.002), social motivation (p=.002), behavioral skills (p=.002), behaviors (p=.003), health-related quality of life (p<.001), and disc height (p=.006) in the experimental group following program implementation, compared to the control group. However, no significant differences were found in lower extremity muscular strength, lumbar lordotic angle, or the visual analog scores for low back pain and leg pain between the two groups. Conclusion: The self-management program developed in this study, based on the IMB model, was effective in improving self-management information, motivation, behavioral skills, behaviors, health-related quality of life, and self-management health outcomes in patients undergoing lumbar spinal stenosis surgery. Nevertheless, future research should aim to verify the long-term effects of such self-management programs by extending the intervention period.

Purpose
Emerging evidence indicates that eating patterns—particularly skipping meals and eating alone—are associated with excess body weight. However, few studies have assessed whether these behaviors contribute to weight gain across different age groups. This study examined the associations of skipping breakfast or dinner, and of eating those meals alone, with overweight or obesity among Korean adults compared to children and adolescents. Methods: This cross-sectional secondary analysis used data from the 2019 Korea National Health and Nutrition Examination Survey. Information on skipping meals, eating alone, and sociodemographic characteristics was obtained via self-report for adults and proxy report for participants under 12 years of age. Overweight or obesity was determined from measured height and weight. Multivariable logistic regression analyses were performed separately by age group. Results: Among adults, eating dinner alone was associated with higher odds of obesity (odds ratio [OR]=1.27, 95% confidence interval [CI]=1.06–1.52). Among adolescents, skipping dinner three or more times per week was associated with higher odds of obesity (OR=2.60, 95% CI=1.04–6.54). No significant associations were observed in children. Skipping breakfast or eating breakfast alone was not significantly associated with overweight or obesity in any age group. Conclusion: Although the cross-sectional design precludes causal inference, the findings suggest age-specific links between eating behaviors and weight status. For adults, reducing solitary dinners may help prevent obesity, whereas for adolescents, preventing frequent dinner skipping could be beneficial. Nursing strategies promoting shared mealtimes in adults and regular dinners in adolescents may help address obesity in Korea.

Purpose
This study aimed to identify sex-specific predictors of microalbuminuria in patients with type 2 diabetes mellitus. Recognizing sex-based differences in risk factors may facilitate the early detection and prevention of diabetic kidney disease. Methods: A cross-sectional analysis was performed using data from the Korea National Health and Nutrition Examination Survey. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Multivariable complex sample logistic regression analyses were conducted separately for male and female. Independent variables included age, duration of diabetes, glycated hemoglobin (HbA1c), fasting blood sugar (FBS), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), TG, HDL-C, waist circumference, and systolic blood pressure (SBP). Results: The prevalence of microalbuminuria was higher in male than in female. In both sexes, longer diabetes duration and elevated SBP were associated with microalbuminuria. Among male, FBS, TG/HDL-C ratio, TG, and low HDL-C were significant predictors. In female, HbA1c showed the strongest association, followed by age and diabetes duration. Conclusion: Sex-specific differences were identified in the predictors of microalbuminuria among patients with type 2 diabetes. Incorporating these differences into early screening and individualized care strategies may help improve the prevention of diabetic kidney complications.

Purpose
The purpose of this study was to examine the experiences of nurse managers in clinical nursing education during an emerging infectious disease outbreak. Methods: Individual semi-structured interviews were conducted with 12 nurse managers from seven general or tertiary hospitals, each with 300 or more beds, in South Korea. Data were collected between February 17 and June 10, 2023, and analyzed using qualitative content analysis. Results: Four themes and 11 subthemes were identified. Nurse managers faced significant challenges in departmental management during the infectious disease outbreak, encountered a wide range of student attitudes toward learning, adapted their teaching methods flexibly in response to changing infectious disease conditions, and ultimately found meaning in the irreplaceable value of clinical practice education. Conclusion: During the emerging infectious disease outbreak, nurse managers not only encountered substantial difficulties but also experienced professional growth as clinical nursing educators. To enhance clinical nursing education in such challenging environments, it is essential to minimize uncertainty caused by infectious diseases and foster positive perceptions among nursing students regarding clinical practice education under restrictive circumstances. Institutional support is also necessary to reduce the work burden on nurse managers.

Purpose
The incidence of gynecological cancers is increasing, presenting significant challenges for patient care and outcomes. Perceived stress and negative affect can impede self-care behaviors and reduce health-related quality of life (HRQoL). This study examined the mediating effects of negative affect and cancer coping on the relationship between perceived hospital stress and HRQoL among patients with gynecological cancer. Methods: A cross-sectional mediation analysis was conducted with 118 gynecological cancer patients recruited from the outpatient clinic of a university hospital (October 2023 to February 2024). Participants completed validated instruments assessing perceived stress, negative affect, cancer coping, and HRQoL. Data were analyzed using Spearman’s correlations and the PROCESS macro (Model 4) with 95% bootstrap confidence intervals (CIs). Results: Perceived stress was significantly correlated with negative affect (r=.58, p<.001), cancer coping (r=.23, p=.012), and HRQoL (r=–.45, p<.001). Negative affect was correlated with HRQoL (r=–.59, p<.001). Furthermore, negative affect and cancer coping mediated the relationship between stress and HRQoL (B=–0.18, 95% CI=–0.27 to –0.11 and B=0.04, 95% CI=0.01 to 0.08, respectively). Conclusion: Negative affect and cancer coping significantly mediated the relationship between hospital stress and HRQoL. Targeted interventions aiming to reduce stress and strengthen emotional and coping strategies could enhance HRQoL among gynecological cancer patients.

Purpose
This study aimed to examine the relationships among death anxiety, attitudes toward death, and burnout in nurses working in hemodialysis units. Methods: A cross-sectional, self-report questionnaire-based survey was conducted. Eighty-six nurses, each with more than one year of experience in hemodialysis units across six general hospitals, participated. Data were collected from July to December 2021. Statistical analyses included Pearson correlation coefficients and multivariate linear regression. Results: The mean death anxiety score was 2.71±0.73 out of 5. Among attitudes toward death, neutral acceptance was most prevalent, with a mean score of 5.48±1.07 out of 7. The average burnout score was 3.94±0.77 out of 7. Death anxiety showed a significant negative correlation with neutral acceptance of death (r=–.33, p=.002) and a significant positive correlation with fear of death attitudes (r=.65, p<.001). Multiple regression analysis identified marital status (being married) (β=–.35, p=.005) and the death attitude of escape acceptance (β=.37, p=.002) as significant predictors of burnout, together explaining 22.3% of the variance (F=2.43, p=.005). Conclusion: Attitudes toward death among hemodialysis nurses may be linked to burnout. Burnout management programs for nurses in hemodialysis units should provide opportunities for neutral discussions and emotional expression regarding death, and should address strategies to mitigate escape acceptance attitudes.

Purpose
Self-rated health in individuals with chronic diseases is influenced by various factors, including dietary adherence and physical activity. However, limited research has investigated how these factors relate to self-rated health among people with chronic kidney disease. Therefore, this study aimed to describe self-rated health and identify its associated factors in this population. Methods: This cross-sectional, secondary data analysis utilized datasets from the seventh Korea National Health and Nutrition Examination Survey, which were collected between 2016 and 2018. A total of 557 participants (mean age=74.8 years) with a glomerular filtration rate of <60 mL/min/1.73 m² were included. Data from health interviews and examinations were analyzed to assess self-rated health, dietary adherence, and physical activity. Descriptive and inferential statistical methods were employed for analysis. Results: Among the 557 participants, 42.6% rated their health as poor. Factors such as sex, age, income, smoking history, anxiety/depression, number of comorbidities, glomerular filtration rate, and physical activity were significantly associated with self-rated health. In contrast, dietary adherence did not exhibit a significant association. Conclusion: Understanding the factors associated with self-rated health can inform the development of nursing interventions aimed at improving self-rated health among patients with chronic kidney disease.

Purpose
This study aimed to develop and evaluate the effectiveness of a health management program using a mobile application for middle-aged men experiencing andropause. Methods: A quasi-experimental design with a non-equivalent control group pretest-posttest structure was employed. The study took place from June 27 to August 30, 2024, with participant recruitment occurring from June 27 to July 10, 2024. In total, 61 participants (30 in the experimental group and 31 in the control group) participated from July 15 to August 20, 2024. The experimental group received an application-based health management program, while the control group did not. Results: The experimental group showed significant improvements in subjective quality of life, health-promoting behaviors, and subjective health status compared to the control group (p<.001). Conclusion: This study confirms that mobile applications can effectively manage health during andropause in middle-aged men. Further research with a larger sample size is recommended to validate these findings.

Purpose
This study aimed to clarify the concept of nursing competence in coping with clinical deterioration by employing Rodgers’ evolutionary concept analysis, which reflects both sociocultural and temporal dimensions. Methods: A six-step concept analysis was conducted following Rodgers’ methodology. A systematic literature review was performed using PubMed, Embase, CINAHL, and Google Scholar, yielding 35 relevant studies published between 2000 and 2025. Data extraction followed the Joanna Briggs Institute template, and quality was appraised using the STROBE checklist. Results: Four key attributes of nursing competence were identified: technical skills in patient monitoring, situational awareness and clinical intuition, decision-making regarding escalation of care, and communication and teamwork to ensure timely intervention. Antecedents included formal education, clinical experience, and institutional support. Consequences encompassed enhanced patient safety, increased nurse confidence, and greater professional autonomy. The concept was demonstrated to be dynamic and influenced by healthcare policies, such as the implementation of rapid response systems. Conclusion: Nursing competence in managing clinical deterioration is a multidimensional and evolving concept that is essential for patient safety. Clarification of this concept can inform the development of assessment tools and simulation-based education. Further research should explore its application across diverse healthcare contexts and address challenges related to escalation of care.

Purpose
This study analyzed the methodological characteristics of machine learning (ML) applications in nursing research, evaluated their reporting quality against standardized guidelines, and assessed progress toward clinical implementation. Methods: A PRISMA-compliant systematic review (PROSPERO CRD42024595877) searched nine English- and Korean-language databases through September 27, 2024. Included studies applied ML to a nursing question and had at least one nursing-affiliated author. Two reviewers independently extracted data following the Cross-Industry Standard Process for Data Mining (CRISP-DM) framework. Reporting quality was appraised using the TRIPOD+AI checklist. Results: Of 125 included studies, supervised learning predominated (93.6%), with random forest, logistic regression, and support vector machines as common algorithms. The most frequent performance metrics were the area under the receiver operating curve and accuracy. Mean TRIPOD+AI compliance was 50.4% (standard deviation=9.37), with reporting quality lowest for data preparation (48.0%) and class imbalance handling (22.4%). Research focused on predicting pressure injuries, falls, and readmissions. Only seven studies described clinical deployment, often citing ethical or workflow barriers. Conclusion: While ML studies in nursing are increasing and show strong discriminatory accuracy, their impact is limited by inconsistent reporting, limited external validation, and rare clinical deployment. Translating these algorithms into practice requires adopting comprehensive reporting guidelines like TRIPOD+AI, documenting each CRISP-DM phase, and integrating nurse-centered decision-support pathways.

Purpose
This descriptive correlational study aimed to evaluate the impact of patient activation on self-management and explore the mediating role of shared decision-making (SDM) among patients on hemodialysis.
Methods
A cohort of 136 participants was recruited from hemodialysis units in Gwangju, South Korea, between August 9 and 22, 2024. Patient activation, self-management, and SDM were assessed using the Patient Activation Measure (PAM-13), the Hemodialysis Self-Management Instrument (HDMI-K), and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9), respectively. Descriptive statistics, Pearson’s correlation analysis, and mediation analysis using the PROCESS macro were conducted to analyze the data.
Results
Patient activation, SDM, and self-management were positively correlated with one another. Mediation analysis showed that patient activation significantly predicted both SDM and self-management. SDM also significantly predicted self-management, confirming its partial mediating effect. The final model explained 54.5% of the variance in self-management. The indirect effect of patient activation on self-management through SDM was statistically significant (indirect effect=0.05, 95% confidence interval [CI]=0.02–0.10). The indirect effect of patient activation on self-management through SDM was statistically significant (indirect effect=0.05, 95% CI=0.02–0.10).
Conclusion
Patient activation directly and indirectly enhances self-management through SDM, verifying the partial mediating role of SDM. Integrating SDM into nursing interventions is essential for effectively supporting self-management in patients undergoing hemodialysis.

Purpose
This study evaluated the effectiveness of an intervention combining the abdominal draw-in maneuver (ADIM) and body mechanics for nurses with chronic low back pain (LBP).
Methods
A non-equivalent control group pretest-posttest design was used, with data collected from August 30 to December 29, 2023. Participants were nurses experiencing chronic LBP (≥3 months) from a university hospital. Participants were allocated by ward units, with the experimental group (n=30) enrolled first, followed by the control group (n=30). The experimental group received ADIM and body mechanics training, performed ADIM exercises three times weekly for 6 weeks, and received daily text reminders. Exercise adherence and body mechanics usage were monitored weekly. The control group received educational materials upon request after study completion. Outcomes included LBP intensity, LBP disability, lumbar flexibility, and body mechanics performance, analyzed using SPSS version 27.0 through descriptive statistics, the chi-squared test, the Fisher exact tests, the independent t-test, the Mann-Whitney U test, and analysis of covariance.
Results
Compared to the control group, the experimental group showed significant reductions in LBP intensity (Z=4.65, p<.001) and LBP disability (F=7.04, p=.010), as well as improvements in lumbar flexibility (t=6.15, p<.001) and body mechanics performance (t=6.91, p<.001).
Conclusion
The intervention effectively alleviated LBP, reduced disability due to LBP, and improved lumbar flexibility and body mechanics performance. Thus, integrating ADIM with body mechanics may represent a practical and beneficial approach for reducing pain and enhancing functional outcomes among nurses experiencing chronic LBP in clinical settings.

Purpose
Over 10% of intensive care unit (ICU) patients die; however, research aimed at assessing and improving the quality of their deaths remains scarce. This study investigated the impact of communication among healthcare professionals and person-centered care provided by ICU nurses on the quality of dying and death (QODD) experienced by ICU patients.
Methods
We measured general characteristics of ICU nurses, interprofessional communication, and person-centered care, and identified their impact on the quality of death for patients who died in the ICU. Participants consisted of 103 ICU nurses employed at two tertiary hospitals in South Korea. Data were collected between January and May 2023. Descriptive statistics, the t-test, analysis of variance, the Mann-Whitney U test, Pearson correlation coefficients, and multiple linear regression analyses were conducted using SPSS version 23.0.
Results
The mean QODD score was 44.73±21.26. QODD was positively correlated with openness (nurse-physician), understanding (nurse-physician), satisfaction (nurse-physician), and person-centered care. Factors significantly influencing QODD included nurse-physician communication, specifically understanding (β=.35, p=.010), and person-centered care (β=.19, p=.033), explaining 20.2% of the total variance (F=7.44, p<.001).
Conclusion
Improved communication among healthcare professionals and enhanced person-centered care are essential for improving the QODD for ICU patients. To achieve this, educational initiatives focusing on end-of-life care and communication training programs for healthcare professionals should be implemented.

Purpose
Falls and medication errors are the most common patient safety incidents globally. Kolb’s experiential learning theory supports the application of cognitive learning in clinical settings. This study examined the effectiveness of Experiential Learning–Based Fall and Medication Error Prevention Education (EFMPE), utilizing virtual reality and room of errors.
Methods
A randomized controlled trial was conducted with 28 fourth-year nursing students (15 experimental, 13 control). The experimental group participated in EFMPE from February 1 to 6, 2024, comprising six sessions of 2 hours each. The control group received traditional lectures. Safety control confidence and course interest were measured before and immediately after the intervention; safety control confidence was reassessed 6 weeks later.
Results
Both groups showed immediate improvement; however, only the experimental group sustained increased safety control confidence after 6 weeks (Wald χ²=13.21, p<.001). Course interest was significantly higher in the experimental group post-intervention (Wald χ²=10.64, p=.001).
Conclusion
These preliminary findings suggest that EFMPE potentially supports the prevention of falls and medication errors in clinical practice.

Purpose
The subjective experiences of middle-aged individuals during the coronavirus disease 2019 (COVID-19) pandemic play a pivotal role in fostering resilience for reintegration into normal life post-pandemic and preparing for potential future infectious disease outbreaks. This study aimed to explore the experiences of middle-aged individuals during the COVID-19 pandemic using the Q methodology.
Methods
Forty-six middle-aged individuals from 10 cities in South Korea participated in this study. The participants arranged and ranked 39 Q statements describing their experiences with the COVID-19 pandemic using a Q-sort table. Subsequently, the data were analyzed using the PQ method.
Results
Three distinct viewpoints were identified: concerns regarding government policies related to COVID-19 (political perspective: consistent government policies are of utmost importance); concerns about personal loss related to COVID-19 (personal perspective: daily life is of the utmost importance); and concerns about social losses related to COVID-19 (social perspective: societal interests take precedence over individual needs).
Conclusion
The nursing interventions recommended for these three factors serve as a strategic blueprint for effectively addressing future outbreaks of infectious diseases. These nursing intervention strategies can significantly enhance positive perceptions of the three identified elements of the COVID-19 experience, providing an opportunity to transform negative outlooks into positive ones.

Purpose
This study aimed to investigate the mediating role of patient safety perception (PSP) in the relationship between the right to know (RtK) and patient participation (PP) among inpatients.
Methods
This descriptive study used a convenience sample of inpatients from three small and medium-sized hospitals in October 2023. A total of 231 inpatients completed a self-report questionnaire assessing PP, RtK, and PSP. Data were analyzed using a mediation model with the PROCESS Macro (Model 4), applying 95% bias-corrected bootstrap confidence intervals.
Results
The findings revealed significant positive correlations between PP and RtK (r=.78, p<.001) and PSP (r=.83, p<.001). Both RtK and PSP had significant effects on PP. PSP was identified as an important mediator in the relationship between RtK and PP (B=.35, boot standard error=.06, 95% confidence interval=.27–.44). The findings confirm that inpatients’ RtK is associated with improved PSP and increased PP.
Conclusion
These findings highlight the critical role of safeguarding patients’ right to information as a strategy for promoting patient safety. To ensure safe and effective care in small and medium-sized hospitals, ongoing support is essential for developing and systematically implementing patient safety education initiatives that actively involve patients.

Purpose
During the coronavirus disease 2019 (COVID-19) pandemic, anxiety and need satisfaction may predict turnover intention among emergency room nurses, with need satisfaction negatively influencing turnover intention. This study aimed to examine the mediating effect of need satisfaction on the relationship between COVID-19–induced anxiety and job turnover intention among emergency room nurses during the pandemic.
Methods
This descriptive cross-sectional study recruited 206 emergency room nurses from 11 hospitals in South Korea. Data were collected using a questionnaire from December 2022 to February 2023.
Results
High COVID-19–induced anxiety was associated with increased turnover intention among nurses. Physiological needs partially mediated the relationship between COVID-19–induced anxiety and turnover intention. However, safety and belongingness needs showed no mediating effect.
Conclusion
During the COVID-19 pandemic, if physiological needs were not satisfied, reducing anxiety and turnover intention among emergency room nurses proved challenging, even when other needs were met. Therefore, physiological needs should be prioritized and addressed before focusing on other types of needs.

Purpose
This study analyzed nursing students’ guided reflective journals following simulation-based practice using standardized patients for the initial care of older adults experiencing falls. It aimed to provide a deeper understanding of how changes in students’ thinking occurred through the learning experience and to describe their levels of reflection.
Methods
An eight-hour simulation-based education program was implemented during a geriatric clinical practicum. The program consisted of orientation, pre-learning activities, simulation practice, and a wrap-up session. Reflective journals from 53 third-year nursing students were analyzed using qualitative content analysis.
Results
Fifty-three third-year nursing students participated and submitted reflective journals. Three categories emerged from the analysis: “preparing for simulation-based practice,” which involved students setting care plans and employing observation; (2) “experiencing patient fall management through simulation-based practice,” where students actively engaged in realistic fall management scenarios; and (3) “critical reflection after simulation-based practice,” encompassing students’ acquisition of new insights and their personal growth. In the first category, students prepared for patient encounters by developing care plans and conducting observations. The second category highlighted realistic fall management scenarios utilizing standardized patients. The third category focused on personal growth through critical reflection. In the 53 reflective journals (185,021 words), level 3 reflections accounted for 31.6% of the content, while level 5, the highest reflection level, comprised only 8.6%.
Conclusion
Post-simulation reflective journaling stimulated critical thinking and self-assessment, enabling nursing students to analyze and reflect deeply on clinical practices. This process reinforced their knowledge base and behavioral foundations essential for clinical practice.

Purpose
This study involved a meta-synthesis of qualitative research concerning the experiences of women with infertility and infertility treatments. Based on an analysis of emotional changes and adaptation processes, it aimed to propose an interaction model encompassing expectation, loss, and resilience and clarify the conceptual meaning of each component.
Methods
Thomas and Harden’s five-step qualitative meta-synthesis methodology was employed. A total of 22 studies published between 2014 and 2024 were comprehensively analyzed and synthesized. The findings were integrated into a model representing the experiences of women undergoing infertility and infertility treatments.
Results
The meta-synthesis identified six key themes: changes in identity and inner growth; strengthening resilience through the roles of spouses, family, and peers; strategies for recovery and growth; support systems amidst economic and social burdens; life in the tension of waiting and hope; and the reconfiguration of couple and family relationships. Based on these themes, a dynamic interaction model, named the Model of Psychological Changes and Resilience (PCR Model), was developed to illustrate the interrelationships among expectation, loss, and resilience. The conceptual implications of these relationships were also explicated.
Conclusion
The cyclical interplay between expectation and loss among women experiencing infertility is intensified by social ideologies and cultural contexts, while resilience is strengthened through overcoming distress and finding meaning in life. Further quantitative research is necessary to validate these relationships in clinical settings by obtaining empirical data that apply this model.

Purpose
This study aimed to suggest directions for legislation regarding medical support tasks in the Nursing Act to promote the advancement of nursing.
Methods
This study reviewed the history of medical support nurses in South Korea and the educational programs for advanced practice providers, both domestically and internationally.
Results
Nurses have performed medical support tasks traditionally carried out by physicians, but legal controversies have persisted. As a result of the escalation of conflicts surrounding policies aiming to increase the physician workforce, training doctors left hospitals. This prompted the initiation of pilot programs allowing nurses to legally engage in medical support tasks, culminating in the enactment of the Nursing Act in September 2024. Internationally, advanced practice providers such as advanced practice nurses (APNs) and physician assistants (PAs) undergo graduate-level education and certification. Since Korea lacks a PA system, integrating medical support tasks within the APN framework would be preferable. Achieving this will require absorbing clinical practice nurses (referred to as PA nurses) into the APN system, implementing government-supported education programs to address regional disparities, and establishing reimbursement policies for APNs.
Conclusion
With the implementation of the Nursing Act, a long-term approach is needed to establish professional qualifications, accreditation, education, training, examination, and regulatory systems. A comprehensive discussion should be undertaken to develop an optimal workforce, ensuring the delivery of safe and high-quality healthcare services to patients and the public.

Purpose
This study aimed to examine the relationship among professor-student interactions, grit, and adaptation to college life.
Methods
In this quantitative, cross-sectional study, participants completed a structured questionnaire comprising 48 items: 8 on general characteristics, 8 on professor-student interactions, 12 on grit, and 20 on adaptation to college life. Data were collected from 165 nursing students at two four-year universities between April 15 and May 20, 2023.
Results
Professor-student interactions had a mean score of 3.76±0.59 out of 5, grit had a mean score of 3.09±0.53, and adaptation to college life had a mean score of 3.48±0.51. Regression analysis identified significant predictors of adaptation to college life, including professor-student interactions (β=.26, p<.001), grit-perseverance of effort (β=.18, p=.047), and satisfaction with the major, with the "very satisfied" (β=.40, p<.001) and "satisfied" (β=.24, p=.002) categories showing significant impacts. The overall regression model was statistically significant (F=20.76, p<.001) and accounted for 32.5% of the variance in adaptation to college life.
Conclusion
Educational programs designed to strengthen professor-student interactions, enhance grit, and improve satisfaction with one's major should be developed to help nursing students adapt to college life. These findings have important implications for nursing education practices, the improvement of student support systems, and the preparation of students for their professional roles.

Purpose
The incidence of diabetes mellitus (DM) rises significantly in the post-middle-age population, and stress along with depressive symptoms hinders effective DM management. This study examined the mediating effect of social capital (trust in the physical environment, reciprocity, social participation, and social networks) on the relationship between perceived stress and depression among middle-aged adults with DM in Korea. It also aimed to provide data for developing targeted interventions to enhance blood glucose management in this population.
Methods
A descriptive correlational study using data from the 2019 Community Health Survey by the Korea Disease Control and Prevention Agency (KDCA) was conducted. Complex sample regression analysis and the Sobel test were employed for mediation analysis. The study included 9,394 middle-aged adults (aged 45-64 years) diagnosed with DM. The analysis assessed the effects of perceived stress on social capital and depression, as well as the mediating role of social capital.
Results
Perceived stress negatively impacted social capital (β=-0.16, p<.001) and positively influenced depression (β=0.37, p<.001). Both perceived stress and social capital significantly affected depression (F=998.83, p<.001), with social capital showing a partial mediating effect (z=2.65, p<.001).
Conclusion
Social capital partially mediated the relationship between stress and depression, suggesting its potential as a strategy for reducing stress and lowering depression among middle-aged adults with DM. These findings lay the groundwork for targeted interventions to improve blood glucose management in this population. Future research should explore the relationships among specific components of social capital, stress, and depression.

Purpose
This study aimed to determine the rates of intensive care unit readmission and to identify the factors influencing readmission among intensive care unit patients aged≥65 years with internal medicine conditions.
Methods
We retrospectively reviewed electronic medical records from a tertiary care hospital in Seoul, analyzing the characteristics of patients who were and were not readmitted between December 2020 and September 2022.
Results
A total of 351 patients were included. The unplanned intensive care unit readmission rate was 4.8% within 7 days and 9.1% beyond 7 days after discharge. Comorbid diabetes, higher total bilirubin levels at intensive care unit admission, lower PaO₂/FiO₂ ratios at discharge, and elevated Blood Urea Nitrogen (BUN) levels at discharge were associated with an increased risk of readmission within 7 days. In contrast, hypertension, prolonged intensive care unit stays, and lower hemoglobin levels at discharge were associated with readmissions occurring after 7 days.
Conclusion
Intensive care unit readmission among older patients is influenced by several clinical and hematological factors. Nurses should consider a patient's history of diabetes and hypertension, length of intensive care unit stay, and laboratory values-specifically total bilirubin at admission, and PaO₂/FiO₂ ratio, hemoglobin, and BUN levels at discharge-when making discharge decisions. These findings can inform the development of discharge guidelines.

Purpose
This study aimed to assess the level of depression among older adults experiencing tinnitus and to identify predictive factors of depression through an analysis of secondary data.
Methods
Data from the ninth Korea National Health and Nutrition Examination Survey conducted in 2022 were utilized for this analysis. We examined individuals aged 60 years or older who had experienced tinnitus for more than 6 months. Complex sample analysis techniques were conducted, and multiple regression analysis was performed to identify predictors of depression.
Results
The study included 231 participants. Significant differences in depression levels were observed across several demographics and health factors, including gender, education level, self-rated health status, living alone, and stress level. Depression levels were significantly correlated with self-rated health status, stress levels, and average sleep duration. Additionally, significant correlations were found between self-rated health and stress levels, self-rated health and the number of chronic diseases, as well as between stress levels and the number of chronic diseases. Multiple regression analysis indicated that self-rated health status (p<.001), stress level (p<.001), and average sleep duration (p=.042) were significantly associated with depression. Specifically, poorer self-rated health, higher stress levels, and shorter sleep duration were associated with higher levels of depression.
Conclusion
In older patients with tinnitus, self-rated health status, stress level, and average sleep duration significantly impact depression levels. These findings provide an important foundation for developing interventions to reduce depression in individuals with tinnitus.

Purpose
The aim of this study was to identify the effects of stigma, social support, and resilience on post-traumatic growth in patients with stroke and to provide foundational data for developing nursing interventions that can effectively promote post-traumatic growth in this population.
Methods
This cross-sectional study employed a questionnaire-based survey. The participants were 150 patients who attended the neurology outpatient clinic three months after a stroke diagnosis. Data were collected between February and April 2024 using a structured self-report questionnaire. Analyses included descriptive statistics, reliability analysis, inferential statistics(independent t-test, one-way ANOVA, and Scheffé's test), and hierarchical multiple regression using SPSS/WIN 27.0.
Results
The mean post-traumatic growth score was 2.52±1.05 out of 5. Significant factors affecting post-traumatic growth were age, education, religion, the presence of a housemate, income, time since stroke onset, stroke type, and stroke recurrence. Post-traumatic growth was positively correlated with social support (r=.44, p<.001) and resilience (r=.53, p<.001), but not significantly correlated with stigma. Regression analysis identified resilience (β=.37, p<.001), religion (β=.29, p<.001), and stroke type (β=.23, p=.033) as significant predictors, explaining 44.2% of the variance in post-traumatic growth (F=9.45, p<.001).
Conclusion
Developing and implementing nursing interventions to increase resilience may be crucial for promoting post-traumatic growth in patients with stroke. Further research is needed to design and evaluate these interventions.

Purpose
This study aimed to explore the roles, facilitators, barriers, and future directions of rapid response teams (RRTs) in Korean hospitals from the perspectives of both RRT and ward nurses.
Methods
Focus group interviews were conducted with 10 RRT nurses and 10 ward nurses across three hospitals that employed RRTs in Korea from August 2021 to February 2022. The interviews were recorded, transcribed, and analyzed using qualitative content analysis to identify themes relevant to RRT operations.
Results
The analysis yielded 10 subtopics and 4 main themes: the exploration of RRT's essential roles, the facilitators and barriers impacting RRT operations, and the construction of a blueprint for future systems. Notable barriers included unclear job assignments without legal safeguards, conflict arising from hierarchical structures, and insufficient organizational support. The following facilitators were identified: transformed perceptions through collaborative efforts, organizational recognition and support, and self-reinforcement by demonstrating expertise.
Conclusion
This study highlights the challenges and opportunities associated with implementing RRTs in Korean hospitals, including the need for clear role definitions, effective interprofessional collaboration, and organizational support. Based on these findings, future efforts should focus on establishing legal frameworks that define the scope of practice for RRT nurses.