HeeKyung Chang

Older adults with cognitive impairment who reside in long-term care facilities (LTCFs) are among the most socially isolated and emotionally underserved populations in contemporary healthcare. Upon ...

Aims and Objectives: To clarify how Ikigai and closely related meaning constructs are described in literature relevant to older people in Korea and to propose a provisional, context‐informed conceptual framework for gerontological nursing. Background: Ikigai , often glossed as “a life worth living,” has been associated with well‐being in later life, yet its meaning and operationalisation vary across settings. Greater conceptual clarity is needed to support culturally responsive nursing assessment and care planning. Methods: Rodgers' evolutionary method of concept analysis (Rodgers, 2000) was used to examine contemporary scholarly use of Ikigai and related concepts in 13 peer‐reviewed studies (published 2002–2024; searched January 2000–June 2025), of which 10 were conducted outside Korea and three in Korea. Data were analysed to identify defining attributes, antecedent contexts, consequences and related concepts. Results: Six defining attributes were identified: psychological equanimity, purposefulness in life, self‐worth and personal value, social connectedness, cultural belonging, and reflective wisdom and self‐integration. Four antecedent contexts were identified: family and intergenerational change, cultural and value transformation, health and functional challenges, and existential and social disconnection. Four consequence domains were identified: emotional stability and psychological balance, active health orientation and functional preservation, life fulfilment and satisfaction, and community integration and social engagement. In literature relevant to older people in Korea, Ikigai was not presented simply as a list of valued sources, but was provisionally interpreted as a process through which relational sources such as family roles, intergenerational continuity and everyday responsibilities may be internalised as an enduring sense of life's worth. Conclusions: Ikigai may be understood as a dynamic and context‐dependent meaning process in later life that includes both valued sources of worth and a sense of life's worth. This review offers a provisional conceptual framework for gerontological nursing and supports further qualitative and measurement research in Korea. Implications for Practice: This framework can support gerontological nurses in assessing meaning, dignity, purpose and relational continuity alongside physical and functional indicators. Nurses may use open‐ended questions and observable indicators to identify valued roles, relationships and routines that sustain older people's sense that life is worth living. Meaning‐centred and culturally responsive care planning may help support participation, autonomy and continuity during later‐life transitions.

Background: Clinical decision-making anxiety impairs nursing students’ relationship-centered care (RCC) delivery, yet the underlying psychological mechanisms remain unclear. Objectives: This study examined the relationship between clinical decision-making anxiety and RCC and also explored the mediating roles of sense of coherence (SOC) and emotional intelligence among nursing students. Methods: A cross-sectional study was conducted from March to May 2024 with 185 nursing students from a 4-year undergraduate program in South Korea. Data were collected using 4 validated instruments: the Korean version of the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, the RCC Scale, the 13-item SOC Scale, and the Wong and Law Emotional Intelligence Scale. Results: Clinical decision-making anxiety negatively affected RCC primarily through indirect pathways. Emotional intelligence significantly mediated this relationship (β = −0.067; 95% Confidence interval [CI], −0.122, −0.024), as did the sequential pathway through SOC to emotional intelligence (β = −0.037; 95% CI, −0.065, −0.014). SOC alone did not significantly mediate the relationship, and the direct effect of anxiety on RCC was nonsignificant (β = −0.027, P = .469). The total indirect effect was significant (β = −0.089; 95% CI, −0.147, −0.043). Conclusion: Clinical decision-making anxiety undermines RCC indirectly through emotional intelligence and the sequential SOC → emotional intelligence pathway rather than through direct effects. Educational interventions that reduce anxiety while systematically developing SOC and emotional intelligence may enhance nursing students’ RCC competency and improve patient outcomes.

Purpose: While capability and opportunity factors in dementia prevention have been extensively studied, the motivational mechanisms that translate these resources into behavior remain relatively underexplored. This study examined the mediating effect of self-efficacy on the relationships between instrumental activities of daily living (IADL), social networks, and dementia-prevention behaviors among community-dwelling older adults, guided by the capability, opportunity, motivation-behavior (COM-B) theoretical framework.Methods: A cross-sectional study was conducted with 205 community-dwelling adults aged 65 years and older residing in Gyeongsangnam Province, South Korea. Data were collected between July and September 2024 using validated instruments, including the Korean Instrumental Activities of Daily Living, Social Network Measurement Scale, General Self-Efficacy Scale, and Korean Health Behavior for Dementia Prevention Scale. Mediation analysis was performed using Hayes’ PROCESS macro (model 4) with bootstrap resampling (5,000 iterations) to estimate indirect effects, while controlling for demographic and health-related covariates.Results: Self-efficacy significantly mediated both the IADL–dementia-prevention behavior relationship (indirect effect, −0.33; 95% confidence interval [CI], −0.61 to −0.12) and the social network– dementia-prevention behavior relationship (indirect effect, 0.08; 95% CI, 0.002 to 0.19). The mediation models explained 40.7% and 48.5% of the variance in dementia-prevention behaviors, respectively. Bootstrap CIs confirmed significant partial mediation effects in both pathways.Conclusion: These findings provide empirical support for the COM-B model’s theoretical proposition that motivation serves as a critical bridge linking capability and opportunity factors to actual behavior. Nursing interventions should therefore integrate self-efficacy–enhancement strategies alongside traditional capability-building and opportunity-provision approaches to maximize the effectiveness of dementia-prevention programs for older adults.

Objective: Given the critical workforce challenges in home care settings and the limited understanding of empowerment mechanisms in isolated work environments, this study aimed to examine how structural empowerment influences psychological empowerment among home care workers in South Korea through the mediating pathways of thriving at work and caregiver reciprocity. Based on Kanter’s empowerment theory, we specifically investigated the serial mediation effects to understand the complex processes through which organizational support structures translate into enhanced worker empowerment. Methods: A cross-sectional survey was conducted with 192 home care workers. Data were analyzed using descriptive statistics, correlation analysis, and serial multiple mediation analysis using SPSS Process Macro Model 6. Results: Structural empowerment demonstrated significant positive correlations with thriving at work (r = 0.445, p < 0.001), caregiver reciprocity (r = 0.490, p < 0.001), and psychological empowerment (r = 0.337, p < 0.001). Thriving at work significantly influenced both caregiver reciprocity (β = 0.3968, p < 0.001) and psychological empowerment (β = 0.1685, p < 0.001). The serial mediation analysis revealed that the indirect effect of structural empowerment on psychological empowerment through thriving at work and caregiver reciprocity was statistically significant (indirect effect = 0.1327, 95% CI [0.0713, 0.1929]), with the model explaining 58% of the variance in psychological empowerment. Conclusions: Structural empowerment significantly enhances psychological empowerment among home care workers through the sequential mediation of thriving at work and caregiver reciprocity. Healthcare organizations should prioritize strengthening structural empowerment through comprehensive support systems and conducive work environments to optimize care quality and worker well-being.

Objective: This study aimed to examine the impact of structural empowerment, thriving at work, and caregiver reciprocity on the psychological empowerment of home care workers in South Korea. Methods: A cross-sectional survey was conducted with 192 home care workers. Data were analyzed using descriptive statistics, correlation analysis, and serial multiple mediation analysis using SPSS Process Macro. Results: Structural empowerment positively influenced job thriving, caregiver reciprocity, and psychological empowerment. Job thriving positively affected caregiver reciprocity and psychological empowerment. Caregiver reciprocity also positively influenced psychological empowerment. The dual mediating effect of job thriving and caregiver reciprocity between structural empowerment and psychological empowerment was significant. Conclusion: High levels of structural empowerment and caregiver reciprocity promote thriving at work, thereby enhancing psychological empowerment among home care workers. These findings highlight structural empowerment as a crucial factor affecting psychological empowerment, with thriving at work and caregiver reciprocity serving as decisive mediators. Healthcare organizations should implement diversified support systems and evaluate working environments to enhance both structural empowerment and caregiver reciprocity for improved care quality.

Park GE, et al. Korean J Adult Nurs. 2025 Feb;37(1):13-24. https://doi.org/10.7475/kjan.2025.37.1.13

Background: A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes. Objectives: To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care. Methods: This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years). Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys. Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program’s outcomes. Results: The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention. Analysis of the residents’ stories identified 5 themes. The staff focus group interviews identified 2 themes and 7 subthemes. Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities. Conclusions: The storytelling program was useful in reducing older adults’ negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction. These effects could help foster relationship- and communication-centered facility cultures.