This study aimed to examine the characteristics and relationships among nurses’ spiritual well-being, self-perceived spiritual needs, nursing work environment, and spiritual care practice in long-term care hospitals. Methods: Participants were 235 nurses working at 16 long-term care hospitals with 300 or more beds located in the Seoul and Gyeonggi regions. Data were collected from February 17 to June 27, 2025, through an online survey platform, with a paper questionnaire provided upon request. Descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression analysis were performed. Results: Significant correlations were identified among spiritual care practice, nurses’ spiritual well-being, self-perceived spiritual needs, and the nursing work environment. In the final regression model, factors influencing spiritual care practice were meaning and purpose (β=0.23, p=.017), existential well-being (β=-0.20, p=.007), marital status (β=-0.19, p=.001), spiritual care education in the current hospital (β=0.17, p=.013), and staffing and resource adequacy (β=0.15, p=.037), explaining 35% of the variance. Conclusion: These findings underscore the importance of developing and implementing spiritual care programs that promote a sense of meaning and purpose, address nurses’ spiritual needs, and thoughtfully support their existential well-being, while ensuring adequate staffing levels and resource allocation within long-term care hospitals. Integrating structured spiritual care education and supportive organizational systems into nursing practice may enhance the quality of holistic care provided to older adults in long-term care hospitals.

This study examined the associations between the types and number of chronic diseases and adverse drug reactions (ADRs) in community-dwelling older adults, aiming to identify high-risk groups and inform nursing strategies for medication safety. Methods: This cross-sectional analysis included 4,478 adults aged ≥65 years from the 2021 Korea Health Panel Survey. Thirty-one physician-diagnosed chronic diseases were grouped into 11 categories, and the number of diseases was classified as 0~1, 2, 3, 4, or ≥5. ADRs were operationally defined using a single self-report item asking whether participants had experienced side effects from any medications, including over-the-counter drugs. Multiple logistic regression analyses adjusted for sociodemographic and health-related covariates were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Arthritis and spinal diseases showed the strongest association with ADRs (OR=2.16, 95% CI=1.44~3.24), followed by depression (OR=2.15, 95% CI=1.22~3.79) and cardio-cerebrovascular diseases (OR=1.86, 95% CI=1.25~2.77). ADR risk increased progressively with multimorbidity: OR=1.87 for two diseases, 2.63 for three, 3.15 for four, and 6.22 for ≥five diseases, compared with 0~1 diseases. Conclusion: ADRs were significantly more likely among older adults with arthritis and spinal diseases, depression, or cardio-cerebrovascular diseases, with risk escalating as multimorbidity increased. Embedding disease type and burden into nursing assessment enables targeted medication review, education, and proactive monitoring. Such nurse-led, collaborative strategies can mitigate drug-related harm and inform policy and training for safe medication use in aging populations.

Behavioral and psychological symptoms of dementia (BPSD) and delirium superimposed on dementia (DSD) can lead to severe complications if they are not accurately identified and managed. Effective dementia care therefore requires clear differentiation, systematic assessment, and appropriate nursing interventions. This study aimed to develop VRDementia: BPSD/DSD, a virtual reality simulation program, and to qualitatively examine its validity and usability as a development-based pilot study. Methods: Using the ADDIE model (Analysis, Design, Development, Implementation, Evaluation), the program was systematically developed. During the analysis phase, qualitative interviews and literature reviews identified educational needs among nurses in long-term care hospitals. Key challenges included distinguishing agitation/aggression (BPSD) from hyperactive DSD, and depression (BPSD) from hypoactive DSD. Based on these findings, four case-based scenarios were created. Content validity and usability were qualitatively evaluated through semi-structured interviews with five experienced nurses (≥5 years of clinical experience). Results: The program consists of four sessions addressing agitation/aggression and depression (BPSD), and hyperactivity and hypoactivity (DSD). Nurses practice symptom assessment, therapeutic communication, physician reporting, and nursing interventions. The simulation is accessible via head-mounted display (HMD), mobile devices, and PC (including laptops). Qualitative feedback indicated that participants perceived the program as useful and applicable for dementia care education, including its potential use in interdisciplinary training contexts. Conclusion: VRDementia: BPSD/DSD is a valid, practical educational tool that improves nurses’ competence in distinguishing and managing BPSD and DSD. This program may contribute to higher quality dementia care in clinical settings.

This study explored the influence of family support, self-care performance and symptom cluster on quality of life (QoL) among individuals with Parkinson’s disease (PD). Methods: A cross-sectional descriptive study was conducted with 132 participants who were over 40 years old and diagnosed with PD from a tertiary hospital in Seoul between September 5 and November 7, 2024. Data were analyzed using descriptive statistics, factor analysis, t-tests, ANOVA, correlation, and hierarchical multiple regression analysis. Results: The explanatory power of the final regression model was 71% (F=17.72, p<.001). The most significant factors affecting QoL were motor symptom clusters (t=4.38, p<.001), emotional/emotion regulation clusters (t=2.90, p=.004), time since diagnosis (t=-3.11, p=.002), having a spouse as the primary caregiver (t=2.55, p=.012), self-care performance in the daily life management domain (t=-2.35, p=.020), and self-care performance in the diet domain (t=-2.01, p=.046). Conclusion: Symptom-cluster–informed, family-centered nursing—integrating motor & emotional management, dietary and daily-life self-care coaching, and early diagnostic pathways with caregiver education—is essential to improve QoL in PD.

This study examined the associations of fall experiences with cognitive function and activities of daily living (ADL) disability among older adults. Methods: Using data from the 2023 National Survey of Older Koreans, a total of 9,816 individuals aged 65 years or older were analyzed. Independent samples t-tests, ANOVA, chi-square tests, linear regression, and logistic regression analyses were conducted. Additionally, subgroup regression analyses were conducted to identify socially vulnerable groups according to age group, education level, and caregiving expenses. Results: The analysis showed that cognitive function tended to be lower in individuals with fall experience (β=-0.44, p=.026), and the odds of ADL disability were higher among individuals with fall experience (odds ratio [OR]=2.04, 95% confidence interval [95% CI]=1.63~2.54). In addition, subgroup analyses showed that cognitive function was lower among individuals with fall experience in the ≥85 years group (β=- 1.30, p=.020) and among those with education at elementary school or below (β=-0.88, p=.001). The odds of ADL disability among those with fall experience were higher among those aged 65~74 years (vs. 75~84; OR=2.80, 95% CI=1.99~3.94) and ≥85 years (vs. 75~84; OR=2.59, 95% CI=1.38~4.84), those with higher education (vs. lower; OR=4.95, 95% CI=1.19~20.60), and those with no caregiving expenses (vs. any; OR=2.06, 95% CI=1.63~2.60). Conclusion: These findings provide important foundational data for both policy development and academic research. They highlight the need for a multifaceted approach to fall prevention and underscore its importance in enhancing the quality of life for the older adults.

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.

This study aimed to investigate the factors influencing end-of-life care competency by examining awareness of person-centered care, knowledge of life-sustaining treatment decisions, and attitudes toward advance directives among nurses in long-term care hospitals. Methods: Through convenience sampling, nurses with more than 6 months of clinical experience and who were responsible for inpatient care in long-term care hospitals in Jennam-do and Gwangju-metropolitan city were selected to participate in this study. Data were collected using a structured self-administered questionnaire between December 1 and 23, 2023. Data were analyzed through descriptive statistics, independent t-test, one-way ANOVA, Scheffé’s test, Pearson’s correlation coefficient, and multiple regression analysis. Results: End-of-life care competency had an average of 3.72 out of 5 points. “Collaboration with team members” had the highest average score and “professional development” the lowest. Multiple regression analysis identified that awareness of person-centered care (β=.31, p<.001), attitudes toward advance directives (β=.31, p<.001), and providing end-of-life care 11 times or more in the past year (β=.17, p=.014) significantly influenced end-of-life care competency. Conclusion: Various educational strategies that promote awareness of person-centered care and foster positive attitudes toward advance directives are needed to enhance nurses’ end-of-life care competency in long-term care hospitals. Additionally, educational programs that provide opportunities for both direct and indirect experience in end-of-life care are needed, as such programs can help establish a system to ensure the delivery of high-quality end-of-life care.

This study aims to investigate the association of lifestyle values with lifestyle and quality of life among community-dwelling late middle-aged and older adults. Methods: This retrospective cross-sectional study analyzed secondary data of 200 late middle-aged and older adults. Lifestyle and lifestyle values were measured by Yonsei Lifestyle Profile (YLP) and YLP-Value, respectively. The mediator was quality of life, and a mediation analysis was conducted to examine the relationship between lifestyle values, lifestyle, and quality of life. Our study then repeated the analysis by dividing lifestyle into three components: physical activity, nutrition/eating habit, and activity participation. Results: Mediation analysis revealed significant associations across all pathways (all p<.001). The lifestyle values were associated with lifestyle (β=.40). Both lifestyle value (β=.40) and lifestyle (β=.18) were positively associated with quality of life. The indirect effect of lifestyle values on quality of life, mediated by lifestyle, accounted for 14.58% of the total effect, with the direct effect constituting 85.42%. Conclusion: Among the three components of lifestyle, a mediation effect was observed between lifestyle values, nutrition/eating habit, and quality of life. Our results indicate the need for education to increase lifestyle values within lifestyle programs, emphasizing the significance of lifestyle values in enhancing both lifestyle and quality of life among late middle-aged and older adults. Health professionals may integrate the results into interventions by recognizing the importance of lifestyle values.

This systematic review evaluates the effectiveness of medication self-management education programs (MSEP) for older adults by analyzing the core characteristics and reported outcomes of successful interventions. Guided by King’s Goal Attainment Theory, this study identifies which program elements, such as scope, provider, and duration, are associated with positive clinical and psychosocial outcomes, aiming to provide evidence-based recommendations for practice and future research amid rising polypharmacy and inappropriate medication use. Methods: A systematic review searched seven databases (up to September 3, 2024) for randomized controlled trials and quasi-experimental studies of medication self-management education for adults 65+. Inclusion followed PICOTS-SD (Participants, Intervention, Comparison, Outcomes, Time, Setting, and Study Design). Quality was assessed (RoB 2.0, ROBINS-I). Data were narratively synthesized, mapping program characteristics to King’s theory (e.g., interaction, transaction) to analyze goal attainment pathways. Results: The 34 included studies demonstrated that MSEP are broadly effective in improving both clinical and psychosocial outcomes. Specifically, comprehensive, multi-session interventions were frequently associated with significant improvements in psychosocial outcomes such as quality of life and self-efficacy, particularly when delivered by multidisciplinary teams or nurses. In contrast, medication-specific programs (14 studies), often led by pharmacists, proved highly effective in enhancing key clinical outcomes, including medication adherence and the reduction of drug-related problems. Conclusion: MSEP effectively enhance adherence. In accord with King’s Goal Attainment Theory, effectiveness is achieved via a ‘transactional’ process. Programs strong in ‘interaction’ (multi-session, nurse-led) achieve psychosocial ‘goal attainment’, while ‘action’-focused programs (pharmacist-led, specific) achieve clinical ‘goals’. The theory may underscore the need for tailored interventions.