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 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 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
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 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
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
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
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
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
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.