Jeung-Im Kim

Purpose: This study aimed to develop a wearable-integrated mobile application prototype for preterm birth risk prevention and to preliminarily evaluate the appropriateness of its content structure and user satisfaction among pregnant women.Methods: A pilot user evaluation study was conducted with 17 community-dwelling pregnant women between 20 and 37 weeks of gestation. Participants used a prototype mobile application integrated with a wearable smart band, Mi Band 7. The application included content on obstetric characteristics, pregnancy stress, preterm birth risk assessment, and QuiPP (quantification of uterine contractions in preterm prediction)-related information. The smart band was used to collect biometric data, with heart rate data included in the present analysis. Preterm birth risk and pregnancy stress were measured using validated short-form scales. Data were analyzed using descriptive statistics and Pearson correlation coefficients.Results: The mean scores for preterm birth risk and pregnancy stress were 10.06±5.02 and 21.35±5.24, respectively. Preterm birth risk was significantly associated with pregnancy stress, r=0.579, p=0.015, supporting the inclusion of pregnancy stress in the application content. No significant associations were found between actual preterm birth and preterm birth risk or pregnancy stress. User satisfaction scores were 3.57±1.27 for the application content and 4.15±0.80 for the smart band.Conclusion: The wearable-integrated mobile application prototype demonstrated preliminary acceptability as an eHealth-based self-monitoring tool for preterm birth risk prevention. Further iterative and longitudinal studies with larger samples are needed to refine the application, validate its predictive potential, and expand it into an artificial intelligence-based personalized nursing intervention.

Purpose: This pilot study aimed to evaluate the feasibility, adherence, and preliminary effects of a home-based digital breathing training program using a smartphone-connected respiratory training platform in pregnant women.Methods: Fourteen pregnant women completed a 6-week home-based digital breathing training program using the Alphasoom platform, a Bluetooth-connected respiratory training device integrated with a smartphone application. The platform provides adjustable airflow resistance, real-time flow monitoring, visual feedback, and automated training record storage to support personalized respiratory training and adherence monitoring. Feasibility outcomes included completion rate, adherence rate, total training sessions, and adverse events. Respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]) and symptom-related outcomes were assessed before and after the intervention.Results: Of the 15 enrolled participants, 14 completed the program, yielding a completion rate of 93.3%. The mean adherence rate was 91.3%, with an average of 27.4 training sessions and an average total training time of 512 minutes. MIP increased from 50.21±5.11 cm H2O to 60.54±4.81 cm H2O (r=0.62, p=0.014), and MEP increased from 65.72± 6.34 cm H2O to 75.90±5.91 cm H2O (r=0.71, p=0.008). Dyspnea-related outcomes showed a tendency toward improvement but did not reach statistical significance. No adverse events were reported.Conclusion: The 6-week home-based digital breathing training program demonstrated high feasibility, adherence, and safety among pregnant women. The program was associated with preliminary improvements in respiratory muscle strength, suggesting its potential as a digital prenatal health intervention. Although subjective symptom improvements were not statistically significant, the intervention may help maintain or stabilize respiratory symptoms during pregnancy. Further studies with larger samples, control groups, and longer follow-up periods are needed to confirm these findings and evaluate broader effects on maternal health.

Toward an end-to-end K-AI nursing ecosystem: digital twins across the care continuum

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.

Background: Psychological stress during pregnancy is common and has been associated with adverse maternal and neonatal outcomes. Digital health interventions (DHIs) have emerged as a scalable approach to support stress management during pregnancy, yet evidence remains fragmented, and prior reviews have largely focused on broad perinatal mental health outcomes or delivery platforms rather than stress-specific effects and targeted intervention components. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of DHIs specifically designed to reduce stress during pregnancy and to examine how intervention strategies and delivery methods are associated with stress outcomes. Methods: We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Randomized controlled trials and quasi-experimental studies involving pregnant women were eligible if they evaluated any digitally delivered intervention—such as mobile apps, web-based programs, or telemedicine—intended to reduce stress, and reported validated stress outcomes. We searched CINAHL, the Cochrane Library, Embase, and PubMed from database inception through November 2025. Risk of bias was assessed using the Cochrane risk of bias 2 tool for randomized trials and the risk of bias in nonrandomized studies of interventions tool for nonrandomized studies. Where appropriate, effect sizes were pooled using random-effects meta-analysis with the Hartung–Knapp–Sidik–Jonkman method and reported as standardized mean differences. Results: A total of 19 studies were included. Overall, DHIs were associated with a significant reduction in stress compared with control conditions (standardized mean difference –0.45, 95% CI –0.59 to –0.32; 95% prediction interval –0.78 to –0.13), with low to moderate heterogeneity. Strategy-based subgroup analyses indicated that mindfulness- and education-focused interventions showed favorable effects, but formal tests for between-subgroup differences were not statistically significant. Evidence certainty was rated as moderate, primarily due to risk-of-bias concerns in some trials. Conclusions: This review provides stress-focused evidence that DHIs can support stress reduction during pregnancy and extends existing literature by systematically disaggregating interventions according to delivery methods, functional features, and content strategies. This study offers a component-oriented synthesis that informs the design and selection of digital stress-management interventions for pregnant women. In real-world antenatal care, these tools may complement clinician-delivered services by expanding access to low-intensity, scalable support, particularly when interventions integrate skills-based content with supportive digital functions. Future research should directly compare single versus combined strategies and evaluate implementation across diverse populations and care settings.

Purpose: This study explored the psychological readiness of pregnant women in the early third trimester by analyzing variations in pregnancy-related stress and childbirth confidence based on general and obstetric characteristics. This study also examined the relationship between psychological factors and the experiences of coronavirus disease 2019 (COVID-19).Methods: A descriptive study involving 137 women between 28 and 32 weeks of gestation was performed. Data were analyzed using IBM SPSS Statistics ver. 28.0, with independent t-tests, 1-way analysis of variance, and Spearman correlation.Results: The mean score for pregnancy-related stress was 35.91±8.72, while that for childbirth confidence was 37.78±9.11. Significant differences were identified in both psychological variables, depending on age, presence of obstetric complications, level of physical activity, and use of prenatal supplements. A significant negative correlation was observed between pregnancy-related stress and childbirth confidence (r=-0.029, p<0.001). Among the general characteristics, COVID-19 experiences demonstrated significant associations with pregnancy stress. Specifically, stress levels were positively correlated with prior COVID-19 infection before pregnancy (r=0.19, p=0.024) and with a family member’s infection during pregnancy (r=0.29, p<0.001).Conclusion: These findings indicate that pregnancy-related stress and childbirth confidence are influenced by various individual and obstetric factors. The COVID-19 infection experience was particularly associated with elevated stress levels. Tailored interventions that address both psychological distress and confidence-building are required to enhance maternal emotional preparedness in the third trimester.

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.

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.