Miran Jung

Purpose: New nurses often experience job stress, reduced self-esteem, and increased turnover intention during their transition to clinical practice. This study examined the effects of self-praise diary writing on these outcomes.Methods: This randomized controlled study with a pretest–posttest design included 62 new nurses (under one year of clinical experience) who completed preceptor training. Participants were randomly assigned either to keep a daily self-praise diary for three weeks or to receive no intervention. Data were analyzed with paired and independent t-tests using SPSS version 22.0. Because baseline job stress differed between the groups, an analysis of covariance (ANCOVA) was additionally performed.Results: The between-group difference in the change scores for turnover intention was not statistically significant (t=-1.68, p=.098). However, significant between-group differences were found in the change scores for job stress (t=-4.58, p<.001) and self-esteem (t=2.33, p=.023). After adjustment for baseline job stress, the group effect on job stress remained significant (F=14.53, p<.001, partial η²=.198).Conclusion: Self-praise diary writing was associated with lower job stress and higher self-esteem immediately after the intervention, but not with turnover intention. Further studies are needed.

Background/Objectives: Because the numbers of middle-aged and older adults living alone in Korea have substantially increased, which warrants greater attention to their health-related quality of life. Therefore, we aimed to develop a predictive model for the health-related quality of life among community-dwelling middle-aged and older adults living alone. Methods: Using 2022 Korea Health Panel Survey data, 1313 participants with complete EQ-5D component data were analyzed. All candidate predictors were entered into benchmarked models without pre-model feature selection. Preprocessing and 5-fold cross-validated hyperparameter tuning were conducted within the training data. Final performance was evaluated on a held-out test set, and the selected model was interpreted using SHAP. Results: XGBoost had the lowest training cross-validated RMSE and was selected as the final explainable model. On the test set, it showed moderate performance (R² = 0.373, MAE = 0.070, RMSE = 0.096), outperforming the mean baseline model (RMSE = 0.121) but remaining comparable with other top-performing models. Predictions were within absolute errors of 0.05 and 0.10 for 45.6% and 76.4% of participants, respectively. SHAP ranked subjective health, age, walking time, need for care, and monthly household income as the five highest-ranked predictors. Other highly ranked predictors included unmet medical needs, total annual out-of-pocket expenditure, disability, anxiety, and regular exercise. Conclusions: These findings may inform targeted interventions and support strategies, although external validation and longitudinal studies are needed to confirm generalizability and causal relationships.

Background/Objectives: Breast engorgement and associated pain, often resulting from milk stasis, impaired circulation, and tissue edema, may adversely affect maternal and neonatal health, as well as maternal mental health and quality of life in early postpartum women. Despite the availability of massage-based methods, the evidence supporting structured self-care programs remains limited. This study aims to develop and evaluate a natural breast self-circulation program and assess its effectiveness in improving breast engorgement, mental health, and quality of life among early postpartum women. Methods: The sample for this quasi-experimental study, comprising both an experimental group (n = 36) and a control group (n = 36), consisted of pregnant women at or before 37 weeks of gestation who intended to breastfeed. Breast engorgement and circumference, stress, anxiety, and EQ-5D-3L scores were measured before and after implementation of the intervention (the natural breast self-circulation program). Results: The program significantly reduced breast engorgement (F = 33.97, p < 0.001, partial η² = 0.327), breast circumference (F = 105.52, p < 0.001, partial η² = 0.601), and anxiety (F = 37.43, p < 0.001, partial η² = 0.348) in women during the early postpartum period. Conclusions: These findings demonstrate that an early postpartum natural breast self-care program can alleviate breast engorgement and maternal anxiety. They provide a rationale for implementing self-managed breast care. Active implementation of this program may help alleviate physical and emotional difficulties and enhance confidence in breast care among pregnant women.

Purpose: This study aimed to provide a comprehensive review of the experiences of peer supporters living with mental illness.Methods: A qualitative meta-synthesis, as outlined by Noblit and Hare, was conducted. Nine qualitative studies were selected and synthesized to explore the experiences of these peer supporters.Results: The synthesis revealed three key themes: "Challenges toward the possibility," "Discovering a role as peer supporter," and "Finding the value of life." And seven subthemes were derived and mapped to each theme to ensure conceptual clarity and consistency across the synthesized findings.Conclusion: The findings of this study enhance our understanding of the experiences of peer supporters with mental illness and can inform the development of prevention programs.

Purpose: This study evaluated the validity and reliability of therapeutic communication responses generated by GPT-5 by comparing different prompt-engineering strategies and identifying optimal methods for psychiatric nursing education. Methods: A methodological design compared four strategies—Zero-shot, Few-shot, Chain-of-Thought (CoT), and Role-prompt—applied to ten psychiatric nursing communication questions. Fourteen experts with over ten years of combined clinical and educational experience rated 40 anonymized responses using a 4-point scale. Inter-rater reliability was assessed with Fleiss' κ and Krippendorff's ⍺ from 400 repeated outputs. Semantic consistency was examined using cosine similarity. Analyses were conducted in Python. Results: Role-prompt showed the highest content validity (mean=3.54±0.39, S-CVI/Ave=0.95), followed by CoT and Zero-shot. Inter-rater agreement was slight (κ=0.07; ⍺=0.15). Semantic consistency was highest for CoT (0.76±0.12) and Role-prompt (0.75±0.11). A Friedman test indicated significant differences among strategies (x2(3)=11.88, p=.008). Conclusion: Role-prompt yielded the most valid therapeutic responses, while CoT produced the most consistent outputs. These findings support the use of Role-prompt and CoT strategies to enhance the validity and reliability of therapy.

Purpose: This study aimed to define nurse burnout syndrome clearly and highlight its distinct characteristics within today's healthcare environments, especially in light of the WHO ICD-11 revision that reclassified burnout as an occupational syndrome. Methods: A concept analysis was conducted using Rodgers' evolutionary method. A systematic literature review was performed using CINAHL and PubMed databases with search terms including 'Nurs*' AND 'Burnout' and related concepts. Results: The analysis identified five defining attributes of nurse burnout syndrome: emotional exhaustion, depersonalization, reduced personal accomplishment, meaning depletion, and somatic complaints. Key antecedents included excessive workload, understaffing, emotional labor, poor organizational support, shift work patterns, and limited job control and autonomy. Consequences included organizational inefficiency, withdrawal behaviors, compromised care quality and patient safety, and deterioration of mental health.Conclusion: This concept analysis provides an expanded definition of nurse burnout syndrome by identifying five core attributes: emotional exhaustion, depersonalization, reduced personal accomplishment, meaning depletion, and somatic complaints. The findings offer a comprehensive framework that clarifies the complexity of this phenomenon and guides the development of measurement tools and intervention strategies in nursing practice, education, and research.

Background/Objectives: Autism spectrum disorder (ASD) is characterized by qualitative difficulties in interaction and communication, as well as hyper- or hypo-responsivity to sensory input, which can substantially challenge the formation of mother-child attachment. This study aimed to identify attachment levels among mothers of preschool-aged children with ASD and to delineate the attachment processes associated with those levels, with the goal of developing a grounded theory explaining these processes. Methods: A two-step study using methodological triangulation was conducted. In the first quantitative study, the attachment level of 64 mothers of children with ASD, under the age of 7 years in Korea, were measured. And 12 were selected for a second study using the grounded theory method of Strauss & Corbin. Results: A significant attachment difference (t = 4.39, p < 0.001) was found in the pregnancy plan. The core attachment category in mothers of pre-school children with ASD was identified as “keep on going with closing the distance”. Eight stages and four types were found in their attachment process. Conclusions: The results of this suggest that it is necessary to develop a personalized intervention strategy and to provide proper nursing by considering the attachment process and type of mothers of children with ASD.

Background/Objectives: Aggression is a major challenge for children with autism spectrum disorder (ASD), their family members, friends, and teachers because it can pose a threat or harm not only to the children with ASD but also to others. This study is a case study aimed at verifying the effectiveness of a virtual reality-based aggression control program for children with ASD. Methods: The participants were two children (one was a 10-year-old boy and the other was a 6-year-old girl) who participated in the ACAA (Aggression Replacement Training for Children and Adolescents with ASD) Program for eight sessions over three weeks. Results: The frequency (C1: 48 → 3; C2: 32 → 3) and severity of aggressive behaviors in both participants decreased after the intervention compared to before. Additionally, overall problematic behaviors were also reduced after the intervention (C1: 85 → 70; C2: 87 → 64). Furthermore, both participants demonstrated a slight increase in their levels of adaptation (C1: 17 → 20; C2: 16 → 18). Conclusions: The effectiveness of the ACAA program has been demonstrated in reducing levels of aggression in children with ASD. Therefore, the ACAA program may contribute to helping aggressive children with ASD live in harmony with others in society and promote independence.

Purpose: This study aimed to define coaching in nursing clearly and elucidate its essential role within the context of contemporary nursing education in clinical settings.Methods: A concept analysis was conducted using Rodgers’ evolutionary method. Literature was extracted from databases such as Web of Science, Medline (PubMed) and CINAHL.Results: Results of analysis led to the development of an operational definition of coaching in nursing characterized as an educational approach focusing on nursing tasks. Coaching in nursing is a systematic and formalized process that can enhance the learning experience through interactive engagement rather than direct instruction. The analysis identified five core attributes of coaching in nursing: nursing task-focused, educational, facilitative, processive, and interactive.Conclusion: The purpose of this concept analysis was to propose a comprehensive definition of coaching in nursing that could align with its theoretical foundation within modern nursing practice. Using Rodgers' evolutionary concept analysis method, related terms, attributes, antecedents, and outcomes were identified, culminating in a detailed definition. This concept analysis provides a contemporary definition of coaching in nursing, clarifying its meaning, ensuring applicability, and offering guidance for future research, education, and clinical practice.