Taejeong Jang

Background: As population aging accelerates, maintaining functional independence among older adults has become a critical public health priority. Cognitive function is a well-established determinant of instrumental activities of daily living (IADL); however, the role of digital literacy in shaping this relationship remains unclear. In the context of increasing digitalization, digital literacy may serve as a key factor supporting aging in place. Therefore, this study aimed to examine the moderating effect of digital literacy on the relationship between cognitive function and IADL among community-dwelling older adults. Methods: This descriptive cross-sectional study was conducted among 147 community-dwelling older adults aged 75 years and older. Cognitive function was assessed using the Korean version of the Montreal Cognitive Assessment (MoCA-K), IADL was measured using the Korean Instrumental Activities of Daily Living (K-IADL) scale, and digital literacy was evaluated using an 11-item dichotomous scale. Data were analyzed using descriptive statistics, Pearson’s correlation analysis, and hierarchical regression analysis. The moderating effect of digital literacy was tested using the PROCESS macro. Results: Cognitive function was positively correlated with digital literacy (r = 0.56, p < 0.001) and IADL (r = 0.26, p < 0.001), and digital literacy was also positively correlated with IADL (r = 0.25, p < 0.001). In the regression analysis, cognitive function significantly predicted IADL (B = 0.11, p = 0.004), but this effect became non-significant after including digital literacy in the model. A significant moderating effect of digital literacy was observed (B = −0.03, p < 0.001). Conditional effects analysis revealed that cognitive function significantly influenced IADL only among older adults with low levels of digital literacy (B = 0.12, p = 0.005), whereas no significant effect was found at moderate or high levels of digital literacy. Conclusions: Digital literacy significantly moderates the relationship between cognitive function and ADL among community-dwelling older adults. These findings suggest that digital literacy may function as a compensatory mechanism that mitigates the impact of cognitive decline on daily functioning. Enhancing digital literacy may represent an effective strategy to promote functional independence and support aging in place in an increasingly digital society.

Background: The extension of life expectancy due to medical advancements has resulted in global aging and increased social costs for elder care. Additionally, stringent health measures related to infectious disease pandemics have adversely affected the quality of life for older adults. This study investigates AI-based interventions to address quality of life issues. Objective: This study systematically examines AI interventions for the older adults, focusing on randomized experimental studies, and aims to provide guidelines for future intervention programs through meta-analysis. Method: A comprehensive meta-analysis that examines the impact of various AI interventions on the overall quality of life experienced by older adults has been conducted, encompassing thirteen randomized controlled trials. Results: The overall effect size of AI intervention programs on the quality of life in the older adults, assessed using the random-effects model, was found to be small (Hedges’ g = 0.30, 95% CI = 0.10–0.51). Additionally, the effect size of quality of life was examined based on the subfactors of the AI intervention program, revealing a range of 5–11 weeks. Robot intervention exhibited a higher effect size than smart device intervention. Conclusion: To improve the quality of life of older adults, further investigation is warranted, including a follow-up study to develop a AI-based intervention program tailored to the type of AI program and intervention duration.

Background: With population aging becoming a global phenomenon, the burden of supporting older adults is increasing. We aimed to present the dimensions and attributes related to the independence of older adults in Korea, in order to aid with development of measurement tools and future interventional programs. Methods: Ten adults who were aged ≥65 years, lived in D city, and could move and communicate independently, were enrolled in this study. The three-stage hybrid model proposed by Schwartz-Barcott and Kim was used for our analysis. The independence levels of older adults, derived from the theoretical stage, were assessed in terms of physical, mental, and environmental dimensions. Results: The independence levels of the participants correlated with tendencies to perform daily life-independent physical activities and self-care, control their lives based on freedom, and actively maintain self-identity. Smoothly interacting with family, neighbors, and support resources while maintaining economic stability and spatial separation represented another critical aspect. Conclusion: The results of this study suggest the need for an interventional approach for older adults at home to establish self-reliance and improve their quality of life in their environments. Moreover, further research is needed to develop a tool to measure the independence of older adults at home, in addition to the development of nursing intervention strategies for successful aging.

The application of the concept of high-performance work system (HPWS) to nurses can improve the quality of nursing care by enhancing nurse supply and patient safety culture. This study aimed to test the validity and reliability of the Korean version of the HPWS Scale (HPWS-K) and verify its adequacy for measuring HPWS within the context of nurses working in Korean hospitals. Data analyses were performed by using data from 214 nurses engaged in patient care in Korean general hospitals with over 300 beds, with SPSS version 22.0 and AMOS version 26.0 software. The data collected were translated into Korean and the adapted Korean version was back-translated into English by bilingual nursing professionals. The content validity of the HPWS-K was tested by administering it to 10 participants, and the collected data underwent reliability and validity testing. In the exploratory factor analysis, the total variance explained was 49.97%, and the instrument’s reliability (Cronbach’s α) was 0.87. A one-factor confirmatory factor analysis showed an acceptable model fit. The results confirmed the feasibility of using the HPWS-K with Korean nurses, and its application in this context is expected to contribute to creating a safe and effective healthcare environment in Korea.

This methodological study aimed to verify the validity and reliability of the Korean version of the Holistic Nursing Competence Scale (HNCS), which comprises five dimensions and 36 items. The English version of the HNCS was forward and backward translated and administered to 251 participants with more than a year of work experience in a general hospital. Data were analyzed using SPSS WIN 24.0(Chicago, IL, USA), and AMOS program was used for confirmatory factor analysis. Additionally, the “Task Performance Evaluation Instrument for Clinical Nurses” was used for concurrent validity. Reliability assessed using Cronbach’s α was 0.969. Convergent, discriminant, and concurrent validity were good. Average variance extracted and construct reliability ranged from 0.845 to 0.932 and 0.980 to 0.987, respectively. The model was suitable with the chi-square value being 1216.563 (df = 584, p < 0.001), and Q value being less than three. Goodness-of-fit index, root mean square residual, and root mean square error of approximation were 0.784, 0.066, and 0.066, respectively. Moreover, comparative fit index, Tucker–Lewis index, and incremental fit index were 0.913, 0.906, and 0.913, respectively. Thus, this study verified the validity and reliability of the Korean version of the HNCS. Our findings suggest that the scale is helpful in measuring and developing the holistic nursing competence of clinical nurses.

Purpose: This study aimed to develop and validate the Stroke Symptom Cluster Scale for Korean Adults (SSCS-K) for stroke survivors. Design: An exploratory sequential study with a mixed-methods design was performed. Methods: In the development stage, a qualitative study with in-depth interviews was conducted with 27 stroke patients. The validation stage involved analyzing the psychometric properties from 288 stroke patients. Findings: The SSCS-K comprising 65 items in six dimensions (mobility, cognition, sensory, mood, communication, and swallowing difficulty) demonstrated acceptable internal consistency (Cronbach’s α = .92–.94). Confirmatory factor analyses with a six-factor solution showed that it explained 62% of the variance in stroke symptoms. The concurrent validity was confirmed with the Stroke-Specific Quality of Life Scale (r = .38–.83, p < .001). Conclusion: The SSCS-K has strong psychometric properties as a measure to assess clustered symptoms in stroke survivors during their long-term rehabilitation. Clinical Relevance: Rehabilitation nurses may consider the SSCS-K as a useful tool for assessing symptoms of stroke survivors.

Stroke survivors suffer from disease-associated symptoms. Tai Chi can be a beneficial approach to provide an adapted form of intervention to manage their symptoms. The study aimed to determine the effects of a Tai Chi-based stroke rehabilitation program on symptom clusters, physical and cognitive functions, and stroke-specific quality of life among stroke survivors in Korea. Thirty-four stroke survivors were randomly assigned to receive either the Tai Chi-based program or the stroke-symptom management program. The feasibility of the program and its effects on the outcomes were assessed at baseline, 3 months, and 6 months. Repeated measures ANOVA showed that most symptoms improved in both groups during the 6-month period, but swallowing-related symptoms improved significantly in the Tai Chi group. Based on the interaction effect, Tai Chi was more effective on flexor muscle strength, ambulation, and activities of daily living and cognitive function over 6 months than their counterparts. Among SS-QOL dimensions, the Tai Chi group showed significant improvements in the thinking and self-care dimensions. The Tai Chi-based stroke rehabilitation program was feasible and safely applicable to stroke survivors in the community settings. This program could improve symptoms, physical and cognitive function, leading to improvements in the self-care dimension of the SS-QOL among stroke survivors.