This study aimed to identify the influencing factors of healthy aging (HA) among frail older adults based on the activity theory of aging. We examined the relationship between perceived health (PH) and HA, with social activity participation (SAP) as a mediator and sex as a moderator. Methods: Secondary data analysis was conducted using data from a national survey of 505 frail older adults in Korea, including measures of PH, SAP, and HA. Analysis utilized SPSS/WIN 29.0 and PROCESS Macro v.4.2 (Model 14). Results: PH was positively correlated with SAP (r=.18, p<.001) and HA (r=.43, p<.001), while the relationship between SAP and HA was not significant (r=-.07, p=.107). PH showed a statistically significant indirect effect on HA through SAP (β=-0.05, BootCI [-0.12~-0.01]), indicating that PH influenced HA both directly and indirectly via SAP. Sex significantly moderated the association between SAP and HA (β=0.24, BootCI [0.08~0.40]), such that SAP was negatively associated with HA in men, whereas no significant association was observed in women. The moderated mediation index was small but significant (β=0.06, BootCI [0.004~0.15]). Conclusion: PH and SAP were significant determinants of HA among frail older adults, with the mediating role of SAP differing by sex. Although activity theory posits that social engagement promotes HA, these findings suggest that sex-specific patterns and individual preferences in social activities should be considered when designing interventions to support HA.

With the increasing trends of an aging population and the rise in single-person households, understanding the concept of well-dying among older adults living alone has become increasingly important. This study aimed to systematically identify the concept of well-dying among older adults living alone. Methods: Schwartz-Barcott and Kim’s hybrid model for concept analysis was employed. In the theoretical phase, a literature review of 1,020 publications was conducted, and 13 relevant articles were selected. In the fieldwork phase, in-depth interviews were conducted with 12 older adults living alone, and the data were analyzed using qualitative content analysis. In the final analytical phase, findings from the theoretical and fieldwork phases were synthesized to define the concept and identify its attributes. Results: The concept of well-dying, as perceived by older adults living alone, is a comprehensive construct encompassing both preparation for death and the dying experience itself. Participants defined well-dying as ‘living independently with health and meaning until the end of life, positively accepting death as a natural process, proactively preparing for death in concrete ways, and ultimately experiencing a dignified and comfortable death without loneliness.’ Conclusion: The findings of this study provide meaningful insights for gerontological nursing practice and health policy development aimed at supporting older adults living alone. These results offer a foundation for designing individualized nursing interventions and community-based programs that promote well-dying, and suggest the need for future validation research in diverse cultural contexts.

Resilience allows older adults to view adversity as an opportunity for growth, making it a key resource for successful aging. This study aimed to develop and validate a multidimensional resilience scale reflecting the characteristics and experiences of community-dwelling older adults. Methods: Preliminary items were generated through a literature review and interviews with eight older adults. Content validity was evaluated by an expert panel, and 510 community-dwelling older adults were recruited using stratified age-group sampling. Construct validity was examined through exploratory and confirmatory factor analyses, while convergent and discriminant validity were also assessed. Concurrent validity was tested against the short form-12 health survey (SF-12) instrument, and Cronbach’s alpha was calculated to determine internal consistency. Results: Two items with item-level content validation index values below .80 were removed. Exploratory factor analysis of the resulting eight-item scale identified two factors (“positive growth and overcoming” and “daily adaptation and self-regulation”), explaining 54.92% of the variance. Confirmatory factor analysis indicated good model fit. Convergent validity and concurrent validity with the SF-12 were supported, while discriminant validity was not. Conclusion: The eight-item, two-factor resilience scale demonstrated acceptable validity and reliability, offering a brief and practical tool for rapid assessment of resilience in community-dwelling older adults. Further research across diverse populations is recommended to enhance its utility in evaluating health promotion programs and strategies for successful aging.

Purpose: This study aimed to examine the effects of nurses' job esteem and positive psychological capital on their intention to stay and to investigate the mediating effect of organizational commitment in these relationships. Methods: A cross-sectional survey was conducted among 107 nurses employed at two general hospitals in Daejeon and Sejong, South Korea, between March and June 2023. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson's correlation coefficients, hierarchical multiple regression, and PROCESS macro (Model 4) with bootstrapping. Results: Nurses' intention to stay was positively correlated with job esteem (r=.52, p<.001), positive psychological capital (r=.47, p<.001), and organizational commitment (r=.60, p<.001). After controlling for gender and total clinical experience, job esteem, positive psychological capital, and organizational commitment explained 48.0% of the adjusted variance in intention to stay (adjusted R2 =.48), with organizational commitment being the strongest predictor. Mediation analysis showed that job esteem had a significant indirect effect on intention to stay through organizational commitment, while its direct effect was not significant, indicating full mediation. In contrast, positive psychological capital did not show a significant indirect effect through organizational commitment but had a significant direct effect on intention to stay. Conclusion These findings suggest that job esteem influences intention to stay primarily through organizational commitment, whereas positive psychological capital exerts a direct effect. Therefore, nurse retention strategies should prioritize organizational interventions that strengthen organizational commitment, along with efforts to enhance job esteem.

Purpose: : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms. Methods: : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis. Results: : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075). Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.

Background: Coronavirus disease 2019 (COVID-19), which has occurred since the end of 2019, has caused tremendous damage not only in terms of disease and death but also in terms of economy. Accordingly, governments implemented health and quarantine policies to prevent the transmission and spread of COVID-19 and minimize economic effects, and implemented various countermeasures to reduce social and economic damage. However, the damage varies from country to country, and there are differences in the response of each government. Methods: Using 2020 data from the Organization for Economic Cooperation and Development countries, the effectiveness of governments’ quarantine and economic policies in response to COVID-19 was calculated, and what factors determine the effectiveness were analyzed. While most of the previous studies analyzed the relationship between the government’s quarantine policy and corona transmission and death, this study is characterized by considering the economic aspect in addition. Results: As a result of the analysis, the following results were obtained. First, when economic aspects are not considered, Asian and European countries have similar levels of efficiency, but when economic aspects are taken into account, Asian countries have higher efficiency. Second, population density had a negative effect on the efficiency of each country’s policy, and long-term orientation was found to have an important impact when considering the economic aspect. Conclusion We found that the governance index is an important variable influencing the efficiency, which shows that the effectiveness of government policies in response to the coronavirus depends heavily on the trust relationship between the government and the people.

Purpose: This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units. Methods: PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types. Results: In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92). Conclusion This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

Purpose: This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units. Methods: PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types. Results: In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92). Conclusion This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

Purpose: This study aimed to examine the effects of the Tai Chi exercise program on cognitive function among older adults at risk of dementia living in rural areas. Methods: A non-equivalent control group with a pretest-posttest design was used. Forty-four subjects at risk of dementia aged over 75 were recruited from the dementia care center in O county. The experimental group participated in the Tai Chi exercise program twice a week for one-hour session for 12 weeks, while the control group received the routine management from the dementia care center. Data were analyzed using the SPSS version 24.0 program with descriptive statistics, x2 test, and Mann-Whitney test, t-test and ANCOVA. Results: The significant improvement was found in cognitive function (F=4.72, p=.036) and attention (F=4.44, p=.041) for the Tai Chi exercise group compared to the control group. No adverse events have been notified during the intervention. Conclusion The study findings suggest that Tai Chi exercise program is safely and effectively applied to older adults at risk of dementia, revealing the potential benefits to improve cognitive function in this population. Further studies are warranted to explore the relationship between physical exercise and cognitive function in older adults with various types of cognitive impairment.

Purpose: This meta-analysis aimed to analyze the effects of smoking prevention programs for young adolescents at early smoking stages to identify the appropriate characteristics of prevention programs for this population. Methods: Searches of health-related databases and Google Scholar were conducted, and 23 randomized studies were included in the analysis. The main outcome variable was smoking behavior. The analysis was conducted using Comprehensive Meta-Analysis software (version 3.0). Results: Smoking prevention programs significantly reduced smoking behaviors (OR=0.85, 95% CI=0.77~0.93). School-based programs (OR=0.79, 95% CI=0.75~0.83), programs by trained teachers or educators (OR=0.77, 95% CI=0.71~0.83), high-intensity programs (OR=0.82, 95% CI=0.75~0.91), and programs in an in-school setting (OR=0.82, 95% CI=0.74~0.90) had the most significant effect on reducing smoking behavior. Conclusion For young adolescents, smoking prevention programs are most effective when they are school-based or highintensity programs, and when conducted by teachers or educators with proper training. Further studies are required since there was insufficient research to explore the effect of web-based programs or family-centered programs on adolescent smokers.