Deterrents to Turnover Intention Among Hospital Nurses in South Korea: A Path Analysis Kyung-Ah Kang, Elizabeth Johnston Taylor, Hye Jin Bae, Jiyoung Chun Journal of Healthcare Management American College of Healthcare Executives, 2026 SUMMARY Goal: High turnover and turnover intention among nurses persists worldwide, necessitating a study of deterrents such as personal spiritual beliefs and posttraumatic growth (PTG). PTG refers to positive psychological changes that occur in response to struggle with highly stressful or traumatic experiences. This study aims to verify a hypothetical model that explains nurse turnover intention in South Korean hospitals since the start of the COVID-19 pandemic. Methods: This descriptive study used path and content analyses and surveyed 268 nurses working in hospitals in Seoul and Busan, South Korea, between March and June 2022, immediately after the height of the COVID-19 pandemic. IBM SPSS Amos was used for the path analysis, and content analysis of open question responses was used to identify the nurses’ personal spiritual beliefs. The study follows the reporting guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Principal Findings: Factors affecting nurse turnover intention with direct effects were job satisfaction, burnout, and PTG. Employer support, job satisfaction, PTG, posttraumatic stress, and importance of spiritual beliefs had indirect effects on turnover intention. Job satisfaction, posttraumatic stress, burnout, PTG, employer support, and importance of spiritual beliefs contributed to total effects. Content analysis identified how 56.9% (of 144 responses) recognized the interplay of spiritual beliefs and PTG; however, 43.1% reported being unaffected spiritually by the pandemic experience. The importance of spiritual beliefs and PTG emerged as deterrents of turnover intention. Practical Applications: Positive practices, such as spiritual beliefs, employer support of nurse well-being, and PTG, directly and indirectly affected nurse turnover intention. This suggests that interventions are needed to enhance nurses’ positive psychological and spiritual resources and practices during times of extreme workplace stress, as was prevalent during the pandemic.
“Meaning in Life” Mediates the Relationship between Loneliness and Depressive Symptoms among Older Adults during the COVID-19 Pandemic Chanhee Kim, Jiyoung Chun Healthcare Switzerland, 2024 Background: Loneliness was found to be a commonly experienced feeling among older adults during the COVID-19 pandemic and is considered to be a high-risk factor for depressive symptoms. Maintaining meaning in life has been found to be a protective resource for mental health among older adults. The purpose of this study was to examine the mediating effects of an individual’s meaning in life in the relationship between loneliness and depressive symptoms among older Korean adults. Methods: The data were obtained from a sample of 213 community-dwelling older adults aged over 65. The instruments were the UCLA Loneliness Scale, the Center for Epidemiologic Studies Depression Scale, and the Meaning in Life Questionnaire. Results: Loneliness was positively associated with depressive symptoms and negatively associated with the presence of and search for meaning among older adults. The presence of meaning mediated the relationship between loneliness and depressive symptoms but the search for meaning did not. The search for meaning mediated the relationship between loneliness and depressive symptoms through the presence of meaning. Conclusions: Our study findings suggest that efforts to reduce loneliness and improve meaning in life should be undertaken to prevent depressive symptoms among older adults.
Initial screening of compassion fatigue in a hospice palliative care team: validation of the silencing response scale Jiyoung Chun, Ye Jean Kim, Kyung-Ah Kang Progress in Palliative Care, 2023 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.
Post-Traumatic Growth of Nurses in COVID-19 Designated Hospitals in Korea Suk-Jung Han, Ji-Young Chun, Hye-Jin Bae International Journal of Environmental Research and Public Health, 2023 Background: This descriptive survey aimed to identify the factors affecting the post-traumatic growth (PTG) of nurses in COVID-19 designated hospitals on the basis of a PTG model. Methods: A survey of 250 nurses working at three COVID-19 hospitals in Seoul, South Korea, was conducted from May to July 2021. The collected data were analyzed using the IBM SPSS 25 (IBM Inc., Armonk, NY, USA). Results: The participants in this study were mostly women (92.7%), and the average age and career duration were 32.08 and 7.88 years, respectively. The factors that significantly influenced the participants’ PTG were identified as marriage, religion, self-disclosure, deliberate rumination, meaning in life, and resilience. Conclusions: As new infectious diseases emerge, it is necessary to develop a program that can encourage self-disclosure and deliberate rumination, help nurses discover and pursue meaning in life, and enhance their ability to overcome trauma and promote PTG.
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, et al. Child Health Nursing Research, 2023 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, <i>p</i>=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, <i>p</i>=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, <i>p</i>=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; <i>p</i>=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, <i>p</i>=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, <i>p</i>=.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.
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, Jiyoung Chun Journal of Hospice and Palliative Nursing, 2022 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.
Effects of a Patient Experience-Based Virtual Reality Blended Learning Program on Nursing Students Hyeon-Young Kim, Jiyoung Chun CIN Computers Informatics Nursing, 2022 When provided with opportunities to view the world from the patients' perspective, nursing students can experience the same practical occurrences and feelings that patients encounter, consequently becoming more aware of their discomfort and pain. This study aimed to evaluate the performance of the patient experience virtual reality blended learning program developed for nursing students. This study is significant in that it presents a program that enables nursing students to not only experience being perioperative patients themselves but also experience their conditions in places other than hospitals, which are generally used as training locations. The analytical results of this study indicated that nursing students who virtually experienced the conditions of perioperative patients through virtual reality blended learning showed increased levels of empathy, positive attitudes toward patient safety treatment, confidence in nursing care, and clinical skill performance. The developed program in this study blended various teaching methods with a virtual reality platform to help junior nursing students with practical and effective perioperative training increase their levels of empathy by simulating the experiences and perspectives of perioperative patients.
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, Jiyoung Chun Journal of Medical Internet Research, 2022 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.
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, Hyeon‐Young Kim Journal of Clinical Nursing, 2021 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.
