Kyung-Ah Kang

Scopus Publications

Effects of a Violence Prevention Education Program Using Empathy (VPEP-E) on Fifth-Grade Students in South Korea
Kyung-Ah Kang, Shin-Jeong Kim, SoRa Kang, and JungMin Lee
SAGE Publications
This study aimed to investigate the effects of a violence-prevention education program using empathy (VPEP-E) on elementary school students. This quasi-experimental design examined fifth-grade students’ (a) empathy level, (b) perception of violence, and (c) permissive and negligent attitudes toward violence, using a pre- and post-test design. A total of 101 students participated: the experimental group ( n = 48) received eight sessions of VPEP-E, whereas the control group ( n = 53) received violence prevention education through classroom lectures. Significant differences were observed between the groups’ empathy level ( t = 6.81, p < .001), perception of violence ( t = 2.79, p = .006), and permissive and negligent attitudes toward violence ( t = -2.21, p = .030; t = -2.02, p = .046). Thus, a school-based VPEP-E may help elementary school students. Long-term studies evaluating behavioral changes from VPEP-E implementation are needed for establishing the effects on violent behavior.

Spiritual Care Expectations Among Cancer and Noncancer Patients With Life-Threatening Illnesses
Kyung-Ah Kang and Shin-Jeong Kim
Ovid Technologies (Wolters Kluwer Health)
Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses. Objective The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses. Interventions/Methods This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis. Results The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: “treat with respect,” “religious support,” and “comfort with presence.” The 3 factors corresponded with 3 themes: factor I versus “treat with respect,” factor II versus “religious ritual,” and factor III versus “comfort with presence.” Conclusions Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients’ spiritual care. Implications for Practice Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.

Effectiveness of a healthy lifestyle program based on a mobile serious game for childhood cancer survivors: A quasi-randomized trial
Kyung-ah Kang, Han-ho Kim, Shin-jeong Kim, In-hye Song, Min-jin Lee, Su-yong Lee, Sae-rom Han, Ki-hyuk Lee, So-won Kim, Hye-rin Nam,et al.
Elsevier BV

The Effects of Symptom Distress and Depression on Quality of Life in Patients with Terminal Cancer: The Mediating Role of Meaning in Life and Spiritual Well-being
Kyung-Ah Kang, Inhye Song, and Myung-Nam Lee
Ovid Technologies (Wolters Kluwer Health)
Background Terminal cancer patients experience worsening physical symptoms, psychological challenges, and spiritual difficulties. Improving the quality of life (QOL) and reconstructing the meaning of life (MIL) for these patients ensure a dignified end-of-life experience. Spiritual well-being is necessary to promote effective end-of-life coping strategies. Objective This study aimed to construct and verify the suitability of a model that explains the impact of physical and psychological factors on the QOL of patients with terminal cancer using MIL and spiritual well-being as mediating factors. Methods The participants were patients with terminal cancer 25 years or older hospitalized in 40 nationally designated hospices. A total of 172 patients were included in the final analysis. Data analysis was performed using structural equation modeling. Results In the effect analysis of the final model, the variables affecting QOL were depression (β = −.62, P < .001), symptom distress (β = −.33, P = .001), and spiritual well-being (β = .36, P = .002), and a significant indirect effect of MIL was found in the depression–MIL–spiritual well-being and depression-MIL-QOL paths. Conclusions Spiritual interventions that help people find their MIL can serve as an important component of optimal hospice and palliative care for patients with terminal cancer. Implications for Practice In clinical practice, interventions that increase the MIL and spiritual well-being of patients with terminal cancer are needed. Additionally, the practice will see other benefits including enhanced patient care, psychological support, effective treatment planning, family caregiver support, and further research advancement.

Effects of School Violence Prevention Education Using a Chatbot (SVPE-C) on Sixth-Grade Students in South Korea
Shin-Jeong Kim, Sunyeob Choi, and Kyung-Ah Kang
SAGE Publications
This study investigated the effects of school violence prevention education using a chatbot (SVPE-C) on sixth-grade students. By applying a pre and posttest design, the students’ (a) degree of knowledge and (b) attitude toward school violence were examined. In addition, (c) satisfaction with the educational method and (d) awareness about SVPE-C were surveyed only in the experimental group. Of the 135 students, the experimental group ( n = 67) received six sessions of SVPE-C with class lectures, whereas the control group ( n = 68) received education only through class lectures. Between the two groups, there were significant differences in the degree of knowledge ( t = 2.837, p = .005) and attitudes toward school violence ( t = 2.98, p = .003). Furthermore, satisfaction with the educational method was significantly higher in the experimental group than in the control group ( t = 2.810, p = .006). Therefore, SVPE-C may be effective for elementary school students.

Infant-rearing experiences of parents during the COVID-19 pandemic in South Korea: a mixed-methods approach
In-Hye Song and Kyung-Ah Kang
Korean Academy of Child Health Nursing
Purpose: This study aimed to identify the infant-rearing experiences of parents during the coronavirus disease 2019 (COVID-19) pandemic and provide foundational data for the development of infant-rearing support programs during pandemic situations. Methods: Convergent mixed methods were used to better understand the research outcomes by converging both quantitative and qualitative data. A total of 149 parents with infant-rearing experiences during the pandemic responded to a self-report survey, and 10 parents participated in the interviews. Data were analyzed using Colaizzi’s method, descriptive statistics, t-test, one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression. Results: Analysis of qualitative data yielded the following three categories: five theme clusters, ten themes, and thirty-nine sub-themes. The factors influencing infant-rearing behavior were nuclear family (β=.34, p<.001) and rearing stress (β=-.39, p<.001). The explanatory power of the regression equation was 26.6%. Conclusion: Infectious disease disasters, such as the COVID-19 pandemic, can quickly alter infant-rearing conditions, causing heightened parental anxiety. This may affect infant-rearing behaviors and hinder healthy infant development. Future research should develop a comprehensive tool to measure holistic health-related parenting behaviors across the different stages of child development. Additionally, pediatric nurse practitioners can play an active role in educating parents, supporting parenting, and promoting healthy infant development in their communities, making pediatric nurse practitioners a highly relevant and necessary healthcare profession during infectious disease disasters. Thus, there is a need to improve institutions and build infrastructure at the national level to support them.

Development of a chatbot for school violence prevention among elementary school students in South Korea: a methodological study
Kyung-Ah Kang, Shin-Jeong Kim, Byoung-doo Oh, and Yu-Hyeon Kim
Korean Academy of Child Health Nursing
Purpose: This study develops a chatbot for school violence prevention (C-SVP) among elementary school students.Methods: Among the analysis, design, development, implementation, and evaluation (ADDIE) models, ADD phases were applied to develop a C-SVP. Students’ learning needs were identified by constructing content with a design that attracted their attention. Subsequently, a formative evaluation was conducted on the developed C-SVP to test its applicability by ten elementary school students targeting the 5th and 6th grades.Results: The chatbot was designed using KakaoTalk and named “School Guardian Angel.” The formative evaluation revealed that the developed C-SVP was easily accessible and useful for elementary school students.Conclusion: The developed C-SVP is expected to be effective in preventing violence among elementary school students. However, further research involving children of various age groups is required.

Awareness of using chatbots and factors influencing usage intention among nursing students in South Korea: a descriptive study
So Ra Kang, Shin-Jeong Kim, and Kyung-Ah Kang
Korean Academy of Child Health Nursing
Purpose: Artificial intelligence (AI) has had a profound impact on humanity; in particular, chatbots have been designed for interactivity and applied to many aspects of daily life. Chatbots are also regarded as an innovative modality in nursing education. This study aimed to identify nursing students' awareness of using chatbots and factors influencing their usage intention.Methods: This study, which employed a descriptive design using a self-reported questionnaire, was conducted at three university nursing schools located in Seoul, South Korea. The participants were 289 junior and senior nursing students. Data were collected using self-reported questionnaires, both online via a Naver Form and offline.Results: The total mean score of awareness of using chatbots was 3.49±0.61 points out of 5. The mean scores of the four dimensions of awareness of using chatbots were 3.37±0.60 for perceived value, 3.66±0.73 for perceived usefulness, 3.83±0.73 for perceived ease of use, and 3.36±0.87 for intention to use. Significant differences were observed in awareness of using chatbots according to satisfaction with nursing (p<.001), effectiveness of using various methods for nursing education (p<.001), and interest in chatbots (p<.001). The correlations among the four dimensions ranged from .52 to .80. In a hierarchical regression analysis, perceived value (β=.45) accounted for 60.2% of variance in intention to use.Conclusion: The results suggest that chatbots have the potential to be used in nursing education. Further research is needed to clarify the effectiveness of using chatbots in nursing education.

Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea: A Nonrandomized Controlled Trial
Kyung-Ah Kang, Shin-Jeong Kim, Do-Bong Kim, Su-Jin Koh, Myung-Hee Park, and Soo-Jin Yoon
Ovid Technologies (Wolters Kluwer Health)
Background Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent. Objective The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT). Methods This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions’ preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ2 test, 1-way analysis of variance, and repeated-measures analysis of variance. Results There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency (P = .002) and spiritual care therapeutics (P = .038), whereas no significant difference was found for compassion fatigue (P = .716). Conclusion The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training. Implications for Practice The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.

Perceptions of the meaning of life among Korean patients with advanced cancer: A mixed-methods study
Su-Jin Koh, Kyung-Ah Kang, Hyeyeong Kim, Jaekyung Cheon, Hyeon-Su Im, Jae-Hon Lee, Minsu Ock, Juhee Cho, and Eun-Hye Lee
Cambridge University Press (CUP)
AbstractObjectiveThis study aimed to explore perceptions of the meaning of life among Korean patients living with advanced cancer.MethodThe study employed a mixed-methods design, and 16 participants were included in the analysis. Qualitative data gathered from in-depth interviews were analyzed using Colaizzi's phenomenological method. Quantitative survey data were analyzed using descriptive statistics, the Mann–Whitney U test, the Kruskal–Wallis test, and Spearman's ρ correlation.ResultsParticipants experienced both the existence of meaning and the will to find meaning in terms of four categories: “interpersonal relationships based on attachment and cohesion” (three themes — family as the core meaning of one's life, supportive and dependent interconnectedness with significant others, and existential responsibility embedded in familism), “therapeutic relationships based on trust” (one theme — communication and trust between the patient and medical staff), “optimism” (two themes — positivity embodied through past experiences and a positive attitude toward the current situation), and “a sense of purpose with advanced cancer” (two themes — the will to survive and expectations for the near future). The meaning in life questionnaire (MLQ) and the purpose in life scale (PIL) showed a significant positive correlation tendency with the functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). The patient health questionnaire (PHQ-9) showed significant negative correlation tendency with both the MLQ-presence of meaning (MLQ-PM) and PIL-Initiative (PIL-I) questionnaires.Significance of resultsFinding meaning in life helps advanced cancer patients realize their will to live. It also acts as a coping mechanism that palliates negative experiences in the fight against the disease. In particular, among advanced cancer patients in the Korean culture, the dynamics of relationships with family and medical staff was a key axis that instilled optimism and will to live. These results suggest that considering the meaning of life in advanced cancer patients by reflecting Korean culture in the treatment process improves the quality of care.

Research trends over 10 years (2010-2021) in infant and toddler rearing behavior by family caregivers in South Korea: text network and topic modeling
In-Hye Song and Kyung-Ah Kang
Korean Academy of Child Health Nursing
Purpose: This study analyzed research trends in infant and toddler rearing behavior among family caregivers over a 10-year period (2010-2021). Methods: Text network analysis and topic modeling were employed on data collected from relevant papers, following the extraction and refinement of semantic morphemes. A semantic-centered network was constructed by extracting words from 2,613 English-language abstracts. Data analysis was performed using NetMiner 4.5.0.Results: Frequency analysis, degree centrality, and eigenvector centrality all revealed the terms ''scale," ''program," and ''education" among the top 10 keywords associated with infant and toddler rearing behaviors among family caregivers. The keywords extracted from the analysis were divided into two clusters through cohesion analysis. Additionally, they were classified into two topic groups using topic modeling: "program and evaluation" (64.37%) and "caregivers' role and competency in child development" (35.63%).Conclusion: The roles and competencies of family caregivers are essential for the development of infants and toddlers. Intervention programs and evaluations are necessary to improve rearing behaviors. Future research should determine the role of nurses in supporting family caregivers. Additionally, it should facilitate the development of nursing strategies and intervention programs to promote positive rearing practices.

Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis
Kyung-Ah Kang, Suk Jung Han, Jiyoung Chun, Hyun-Yong Kim, Yerin Oh, and Heejin Yoon
Korean Academy of Child Health Nursing
Purpose: This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS).Methods: Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software.Results: Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance.Conclusion: Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

Psychometric validation of the Child Healthy Lifestyle Profile in South Korea: a cross-sectional study
Kyung-Ah Kang and Shin-Jeong Kim
Korean Academy of Child Health Nursing
Purpose: This study aimed to validate the Child Healthy Lifestyle Profile as an instrument for screening healthy behaviors in school-aged children in South Korea.Methods: Self-reported questionnaires were administered to 454 students, comprising elementary-school students (n=221) and child cancer survivors (n=233). Reliability and validity were assessed using Cronbach's ⍺, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).Results: Cronbach's ⍺, as a reliability test, was 0.87. Varimax rotation yielded nine factors with eigenvalues greater than 1 in the EFA, which explained 61.0% of the total variance. In the CFA, both convergent and discriminant validities were acceptable. Therefore, the Child Healthy Lifestyle Profile was validated as an assessment tool for Korean school-aged children.Conclusion: Based on the results of this study, the Child Healthy Lifestyle Profile was identified as a reliable and valid instrument for assessing healthy lifestyles in elementary-school children in South Korea.

Initial screening of compassion fatigue in a hospice palliative care team: validation of the silencing response scale
Jiyoung Chun, Ye Jean Kim, and Kyung-Ah Kang
Informa UK Limited
Aims and Objectives: This study aimed to validate a silencing response scale (SRS) for the initial screening of compassion fatigue in hospice palliative care teams (HPCT) members. Background: The silencing response is a defense mechanism that diverts caregivers’ attention from painful and difficult situations. This is an early stage of compassion fatigue. During the silencing response stage, the ability of HPCTs to listen to patients’ requests for assistance decreases, and their professional performance related to tasks and care provision weakens. Design: This study with psychometric evaluation was designed to validate the SRS for the initial screening of compassion fatigue among HPCTs. Methods: After translation-back translation and content validity indexing, 236 HPCT members working in hospice agencies designated by the Korean Ministry of Health and Welfare participated in this survey. The data were analyzed using SPSS and AMOS software. Results: The SRS developed in this study is a self-evaluation tool that employs a five-point Likert scale with 16 items: eight for disinterest, four for situation avoidance, and four for fear. The SRS met the criteria for construct, convergent, and criterion validity. The Cronbach's α for the full SRS was .87. Conclusions: To ensure HPCT well-being, prevention rather than burnout recovery should be prioritized. The SRS developed in this study can be used to screen for compassion fatigue at an early stage to prevent burnout and severe compassion fatigue among HPCT members.

Healthy lifestyle status related to alcohol and food addiction risk among college students: a logistic regression analysis
Cheong Hoon Kim, Kyung-Ah Kang, and Sunhwa Shin
Informa UK Limited
OBJECTIVE This study aimed to determine whether low healthy lifestyle (HL) status was associated with alcohol and food addiction risks among college students. METHOD The data were gathered through an online survey questionnaire from 311 college students. The students were divided into either a lower or a higher HL status group, based on HL mean score, and the major statistical method used was a binary logistic regression. RESULTS There were significant differences in alcohol and food addiction score between the two groups. The lower HL status group showed a 3.06 times higher risk of problematic drinking and a 2.44 times higher risk of food addiction compared with the higher HL status group. CONCLUSIONS The results of this study suggest the importance of HL in the prevention of alcohol and food addiction. HL information can be used to develop health education programs aimed at preventing addiction for college students.

Nurse Spiritual Care Therapeutics Scale: Validation Among Nurses Who Care for Patients With Life-Threatening Illnesses in South Korea
Kyung-Ah Kang, Elizabeth Johnston Taylor, and Jiyoung Chun
Ovid Technologies (Wolters Kluwer Health)
Although clinical and empirical literature documents the variety of spiritual care interventions available to palliative care clinicians, the frequency with which they are provided is rarely and inadequately measured. Given the growing interest in implementing spiritual care across Asia, including South Korea, this study sought to cross-culturally validate the Korean version of the Nurse Spiritual Care Therapeutics Scale (NSCTS-K), a scale initially developed in the United States. The World Health Organization process for cross-cultural adaptation of scales and Polit and Yang's process for evaluating validation were implemented. With data from a sample of 252 Korean nurses providing care to patients with life-threatening illnesses, various statistical procedures for evaluating validity and reliability were applied during this cross-sectional, observational study. Exploratory factor analysis for the structural validity of the Korean scale generated 3 factors that accounted for 69.40% of the variance. The Cronbach α was 0.95. The NSCTS-K is one of the few scales available to determine the impact of nurse-provided spiritual care frequency on patient outcomes. Thus, this tool can quantify the frequency of spiritual care better and be used in quality improvement initiatives or palliative care research.

Content Analysis of Multifaceted Needs for Improving the Quality of Pediatric Palliative Care Among Parents of Children With Life-threatening Conditions
Kim Cho-Hee, Kim Min-Sun, Moon Yi-Ji, Shin Hee-Young, Lee Myung-Nam, and Kang Kyung-Ah
Ovid Technologies (Wolters Kluwer Health)
This study aimed to identify parental needs for pediatric palliative care and obtain their opinions on developing pediatric palliative care in South Korea. This qualitative research design used inductive and deductive methods. The data were collected through semistructured interviews. A total of 6 parents actively caring for a child with life-threatening conditions and 7 bereaved parents participated in this study. A total of 707 significant statements, 43 subthemes, and 16 themes according to 6 structured matrices (advance care planning and symptom control, psychological and spiritual care, supporting everyday lives, end-of-life care and bereavement support, delivery model of pediatric palliative care, and unmet needs within current services) on the care and bereavement experiences of parents of children with life-threatening conditions were derived. Palliative care for children is a multidisciplinary approach to evaluate, prevent, and manage multifaceted symptoms and to support children with life-threatening conditions and their families. Our findings suggest that parents of children with life-threatening conditions in South Korea present multidimensional needs across the diagnostic groups and the illness trajectories and inform policy makers and health care professionals to design a pediatric palliative care delivery model. Further studies examining the unmet needs are required to enhance the quality of pediatric palliative care.

Elementary school students' awareness of the use of artificial intelligence chatbots in violence prevention education in South Korea: a descriptive study
Kyung-Ah Kang, Shin-Jeong Kim, and So Ra Kang
Korean Academy of Child Health Nursing
Purpose: This study aimed to identify students' awareness of the use of a chatbot (A-uC), a type of artificial intelligence technology, for violence prevention among elementary school students. Methods: The participants comprised 215 students in the fourth to sixth grades in Chuncheon, South Korea, and data were collected via a self-reported questionnaire. Results: The mean A-uC score was 3.43±0.83 out of 5 points. The mean scores for the 4 sub-dimensions of the A-uC tool were 3.48±0.80 for perceived value, 3.44±0.98 for perceived usefulness, 3.63±0.92 for perceived ease of use, and 3.15±1.07 for intention to use. Significant differences were observed in A-uC scores (F=59.26, p<.001) according to the need for the use of chatbots in violence prevention education. The relationships between intention to use and the other A-uC sub-dimensions showed significant correlations with perceived value (r=.85, p<.001), perceived usefulness (r=.76, p<.001), and perceived ease of use (r=.64, p<.001).Conclusion: The results of this study suggest that chatbots can be used in violence prevention education for elementary school students.

Effects of Child Sexual Abuse Prevention Education Program Using Hybrid Application (CSAPE-H) on Fifth-Grade Students in South Korea
So Ra Kang, Shin-Jeong Kim, and Kyung-Ah Kang
SAGE Publications
The purpose of this study was to test the effects of a child sexual abuse prevention education program using a hybrid application (CSAPE-H) by examining fifth-grade students’ (a) knowledge for sexual abuse prevention and (b) self-protective behaviors against sexual abuse. A quasi-experimental, pretest /posttest design was used. Sixty-eight students from two schools participated. The intervention group ( n = 48) received six sessions in CSA prevention education using the hybrid app, whereas the control group ( n = 35) was taught using a lecture in a classroom environment. Between the two groups, there were significant differences in self-protective behaviors against CSA ( t = 2.26, p = .027). In addition, educational satisfaction was significantly higher in the experimental group than the control group ( t = 2.41, p = .019). A CSAPE-H may be effective for elementary school students, especially for self-protective behaviors.

Healthy lifestyles in childhood cancer survivors in South Korea: a comparison between reports from children and their parents
Kyung-Ah Kang, Shin-Jeong Kim, and Inhye Song
Korean Academy of Child Health Nursing
Purpose: This study investigated childhood cancer survivors' behavior related to a healthy lifestyle during their survival period by comparing reports between childhood cancer survivors and their parents.Methods: In this comparative descriptive study, a survey was conducted with a 33-item questionnaire and one open-ended question about areas for improvement. The participants comprised 69 childhood cancer survivors and 69 of their parents, for a total of 138.Results: The total mean healthy lifestyle score, on a 4-point Likert scale, reported by childhood cancer survivors was 2.97, while that reported by their parents was 3.03. No significant differences in children's healthy lifestyles were found between childhood cancer survivors' and their parents' reports (t=0.86, p=.390). For the open-ended question, the main keywords based on the results of degree and eigenvector centrality were "exercise", "unbalanced diet", and "food". These keywords were present in both the children's and parents' responses.Conclusion: Obtaining information on childhood cancer survivors' healthy lifestyles based on reports from themselves and their parents provides meaningful insights into the improvement of health care management. The results of this study may be used to develop and plan healthy lifestyle standards to meet childhood cancer survivors' needs.

Web-Based Research Trends on Child and Adolescent Cancer Survivors over the Last 5 Years: Text Network Analysis and Topic Modeling Study
Hyun-Yong Kim, Kyung-Ah Kang, Suk-Jung Han, and Jiyoung Chun
JMIR Publications Inc.
Background Being diagnosed with cancer during childhood or adolescence can disrupt important periods in an individual’s physical, psychosocial, and spiritual development and potentially reduce the quality of life (QOL) after treatment. Research is urgently required to improve the QOL for child and adolescent cancer survivors, and it is necessary to analyze the trends in prior research reported in international academic journals to identify knowledge structures. Objective This study aims to identify the main keywords based on network centrality, subgroups (clusters) of keyword networks by using a cohesion analysis method, and the main theme of child and adolescent cancer survivor–related research abstracts through topic modeling. This study also aims to label the subgroups by comparing the results of the cohesion and topic modeling. Methods A text network analysis method and topic modeling were used to explore the main trends in child and adolescent cancer survivor research by structuring a network of keyword (semantic morphemes) co-occurrence in the abstracts of articles published in 5 major web-based databases from 2016 to 2020. A total of 1677 child and adolescent cancer survivor–related studies were used for data analyses. Data selection, processing, and analyses were also conducted. Results The top 5 keywords in terms of degree and eigenvector centrality were risk, control interval, radiation, childhood cancer treatment, and diagnosis. Of the 1677 studies used for data analyses, cluster 1 included 780 (46.51%) documents under risk management, cluster 2 contained 557 (33.21%) articles under health-related QOL and supportive care, and cluster 3 consisted of 340 (20.27%) studies under cancer treatment and complications. Conclusions This study is significant in that it confirms the knowledge structure based on the main keywords and cross-disciplinary trends in child and adolescent cancer survivor research published in the last 5 years worldwide. The primary goal of child and adolescent cancer survivor research is to prevent and manage the various aspects of the problems encountered during the transition to a normal life and to improve the overall QOL. To this end, it is necessary to further revitalize the study of the multidisciplinary team approach for the promotion of age-specific health behaviors and the development of intervention strategies with increased feasibility for child and adolescent cancer survivors.

Spiritual needs among Koreans and Americans with advanced chronic illnesses: A cultural comparison
Iris Mamier, Sun Min Kim, Denise Petersen, Hye‐Jin Bae, Elizabeth Johnston Taylor, and Kyung‐Ah Kang
Wiley
AIMS AND OBJECTIVES This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross-cultural perspective. BACKGROUND Persons with serious or life-limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well-being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. DESIGN A quantitative, cross-sectional, observational cross-cultural comparison was undertaken. METHODS The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness-related variables were also assessed using paper-and-pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. RESULTS The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self-reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. CONCLUSIONS In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. RELEVANCE TO CLINICAL PRACTICE Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in-depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs.

Correction to: A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation (BMC Palliative Care, (2021), 20, 1, (30), 10.1186/s12904-021-00718-1)
Kyung-Ah Kang, Shin-Jeong Kim, Do-Bong Kim, Myung-Hee Park, Soo-Jin Yoon, Sung-Eun Choi, Young-Sim Choi, and Su-Jin Koh
Springer Science and Business Media LLC

A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation
Kyung-Ah Kang, Shin-Jeong Kim, Do-Bong Kim, Myung-Hee Park, Soo-Jin Yoon, Sung-Eun Choi, Young-Sim Choi, and Su-Jin Koh
Springer Science and Business Media LLC
Abstract Background Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). Methods The modules’ content was informed by Viktor Frankl’s meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants’ demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). Results We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs’ SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). Conclusions The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.

Hospice palliative care nurses’ perceptions of spiritual care and their spiritual care competence: A mixed-methods study
Kyung‐Ah Kang, Jiyoung Chun, Hyun Yong Kim, and Hyeon‐Young Kim
Wiley
AIMS AND OBJECTIVES To understand hospice palliative care nurses' (HPCNs) perceptions toward spiritual care and their competence to provide spiritual care. BACKGROUND Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients' spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited. DESIGN A mixed methods research design was used. METHODS Quantitative data were collected from 282 nurses in forty Hospice Palliative Care (HPC) institutions in South Korea and analyzed using descriptive statistics, independent t-test, one-way ANOVA with Bonferroni test, and multiple regression. Qualitative data collection involved two stages: first, an open-ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative datasets were analyzed separately using content analysis. This study followed the GRAMMS guidelines. RESULTS Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in "attitude toward the patient's spirituality" and "communication," whereas the "assessment and implementation of spiritual care" and "professionalization and improving the quality of spiritual care" had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care, and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardized terminology, and the opportunity to reflect on nurses' own spirituality. CONCLUSIONS Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance. RELEVANCE TO CLINICAL PRACTICE The results of this study provide a useful resource to develop educational programs for strengthening the SCC of nurses and the entire HPC team.

Kyung-Ah Kang

EDUCATION

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