Purpose:This study aimed to identify the mediating effect of dyadic coping and the actor-partner effects of infertility-related stress, dyadic coping, and subjective happiness among infertile couples by applying the actor-partner interdependence mediation model. Methods:A total of 115 infertile couples, comprising women diagnosed with primary infertility and their spouses, participated in an online survey. Data were collected between November 17, 2022 and January 9, 2023, and analyzed using IBM SPSS Statistics version 25.0 and SmartPLS version 4.0.9.2 with the path weighting scheme. Bootstrapping with 5,000 resamples was performed to estimate 95% confidence intervals. Results:Significant correlations were observed between infertile women and their spouses in infertility-related stress, dyadic coping, and subjective happiness, indicating mutual psychological influence within couples. Infertility-related stress in both women and spouses had actor effects on their own dyadic coping and subjective happiness. Women's dyadic coping had an actor effect on their own subjective happiness, whereas spouses' dyadic coping had a partner effect on women's subjective happiness. Among women with infertility, dyadic coping significantly mediated the association between infertility-related stress and subjective happiness. A significant partner-mediated effect was also observed for women's subjective happiness, whereas no significant mediating effect was found for spouses' own subjective happiness. Conclusion:Infertility-related stress was associated with subjective happiness through dyadic coping among women with infertility. In addition, spouses' infertility-related stress was indirectly associated with women's subjective happiness through spouses' dyadic coping. These findings suggest that interventions designed to strengthen dyadic coping may help reduce infertility-related stress and improve subjective happiness among infertile couples.
Purpose:This study aimed to develop a scale for assessing nurses' situation awareness of clinical deterioration and to evaluate its validity and reliability. Methods:This methodological study followed the scale-development guidelines of DeVellis and Thorpe. Item generation began with 44 items derived from 17 attributes identified through a hybrid-model concept analysis, which included a literature review and focus group interviews with 13 nursing experts. After content validity was evaluated by seven experts, 30 items were retained. A pilot test was then conducted with 20 hospital nurses to assess item comprehensibility. From August 30 to October 6, 2025, a total of 446 hospital nurses participated in the survey, and data from 440 respondents were analyzed. Construct validity was examined using exploratory and confirmatory factor analyses, along with convergent and discriminant validity testing. Internal consistency was evaluated using Cronbach's α and McDonald's ω. Results:Exploratory factor analysis yielded a three-factor model, which showed acceptable fit in confirmatory factor analysis. The final instrument comprised 24 items across three factors, was scored on a 5-point Likert scale, and was named the Nurses' Situation Awareness Scale for Clinical Deterioration (NSAS-CD). The scale showed high internal consistency, with Cronbach's α of .98 and McDonald's ω of .98. Conclusion:The NSAS-CD demonstrated acceptable validity and reliability for assessing nurses' situation awareness of clinical deterioration. Further research is needed to evaluate its generalizability across diverse clinical settings and to establish standardized criteria for clinical deterioration.
Purpose:Head and neck cancer is frequently diagnosed at an advanced stage and is associated with substantial mortality. Patients also experience major physical limitations and psychosocial distress. This study explored the subjective meaning of illness experiences among patients with head and neck cancer using interpretative phenomenological analysis (IPA). Methods:This qualitative study used IPA to examine the experiences of eight adults with stage II-IV head and neck cancer recruited from two university hospitals. All participants had undergone surgery followed by radiotherapy or chemoradiotherapy at least 6 months before data collection. Data were collected through in-depth interviews conducted from February to June 2022 and were analyzed using the cyclical IPA procedure. Results:Four superordinate themes were identified: (1) being overwhelmed by lamentation and fear when confronting a late-diagnosed illness; (2) confronting human limitations during treatment undertaken for survival; (3) losing daily life and selfhood while living in a body that had not recovered; and (4) reconstructing life beyond the fear of recurrence. Participants experienced diagnosis and treatment as traumatic and described persistent functional impairments and painful sequelae. Conclusion:These findings provide an in-depth understanding of the illness experiences of patients with head and neck cancer and offer evidence to inform nursing interventions that support adaptation and quality of life.
Purpose:This study examined the effects of continuous glucose monitoring (CGM)-guided personalized lifestyle coaching on glycemic outcomes and glycemic variability in patients with type 2 diabetes mellitus (T2DM). Methods:This three-arm randomized controlled trial was conducted in South Korea from June 2023 to November 2024. Participants were assigned to CGM alone (Intervention I, n=34), CGM-guided personalized lifestyle coaching (Intervention II, n=34), or standard diabetes education (control, n=34). The intervention lasted 3 months, with assessments at baseline and at 3, 6, and 12 months. Data were analyzed using generalized estimating equations. Results:At 3 months, glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) levels were significantly lower in both intervention groups than in the control group. Compared with the control group, HbA1c was lower by 0.78 percentage points in Intervention I (p=.008) and by 1.12 percentage points in Intervention II (p<.001). At 3 months, FPG was lower than in the control group by 34.05 mg/dL in Intervention I (p=.001) and by 34.77 mg/dL in Intervention II (p<.001). At 6 months, TBR70 (time below range <70 mg/dL) was lower in Intervention I than in Intervention II (adjusted mean difference=-2.18, p=.010), whereas TAR180 (time above range >180 mg/dL) was lower in Intervention II than in the control group and Intervention I by 7.85 and 8.28 percentage points, respectively (both p=.004). Conclusion:CGM-guided personalized lifestyle coaching improved glycemic control and reduced hyperglycemic exposure in patients with T2DM. Real-time glucose data may support individualized lifestyle counseling and sustained diabetes self-management. This study was retrospectively registered with the Clinical Research Information Service (CRIS) of the Republic of Korea (KCT0008872) on 16 October 2023.
Purpose:This study aimed to determine whether placing anti-smoking campaign messages in designated smoking areas elicits psychological reactance among female smokers and to assess whether message framing (controlling vs. non-controlling) moderates the association between psychological reactance and intention to quit smoking. Methods:A quasi-experimental survey was conducted with 259 female smokers. Of these, 58 participants completed the survey before exposure to smoking-cessation messages, and 201 completed the survey after exposure. Among the exposed participants, 100 were assigned to the controlling condition and 101 to the non-controlling condition. Measures included psychological reactance, intention to quit smoking, trait reactance, smoking disclosure, and smoking-related covariates. Data were analyzed using analysis of covariance and Hayes' PROCESS Model 1, with statistical significance set at p<.05. Results:Smokers exposed to anti-smoking messages within designated smoking areas reported higher psychological reactance (mean±standard deviation: 2.10±0.94) than those not exposed (1.81±0.77), with a significant between-group difference (p=.017). Simple slope analysis revealed that psychological reactance was negatively associated with quit intention under controlling messages (B=-0.20, p=.031), but not under non-controlling messages (B=-0.05, p=.591). Conclusion:Exposure to anti-smoking messages within designated smoking areas was associated with increased psychological reactance toward smoking cessation. In contrast, autonomy-supportive, non-controlling messages attenuated this effect. These findings suggest that smoking areas may serve as strategic behavioral intervention points when campaigns employ context-sensitive, autonomy-supportive message framing. This study was registered with the Clinical Research Information Service (CRIS) of the Republic of Korea (KCT0012514) on 27 August 2026.
Purpose:This study used a system dynamics approach to analyze the feedback structure underlying regional imbalance in the nursing workforce in Korea and to evaluate the projected effects of policy interventions through simulation. Methods:A system dynamics model was developed using literature and public statistics from the Graduate Occupation Mobility Survey and the Korean Statistical Information Service for 2009-2024. Model validity was assessed through sensitivity analysis and comparison with historical data from 2018-2022. Policy simulations covering 2020-2035 were conducted to compare interventions targeting wages and working conditions in Seoul and Jeonnam. Results:The analysis identified 16 feedback loops, comprising 13 reinforcing loops and three balancing loops, that formed a "success to the successful" structure dominated by a reinforcing cycle of high turnover. In the baseline simulation, the regional gap widened through 2035. Single-factor scenarios involving wage increases or improvements in working conditions had limited effects, whereas high-intensity combined scenarios showed a synergistic effect that could reverse the projected imbalance. Conclusion:Regional imbalance in the nursing workforce appears to be a structural problem that is unlikely to be resolved through single-factor policies. Sustained, high-intensity strategies that combine wage improvement with nonfinancial improvements in working conditions are likely needed to disrupt the reinforcing cycle and reduce the nursing workforce imbalance.
Purpose:This study systematically analyzed the job duties of nurses in acute psychiatric intensive care units using the Developing A Curriculum (DACUM) technique and identified the core job structure that reflects the characteristics of acute mental health nursing. Methods:This descriptive cross-sectional study used a DACUM workshop conducted in 2025 to identify job duties. The DACUM committee included one job analysis expert, one coordinator, and eight acute psychiatric nurses. Content validity was verified by eight experts using an item-level content validity index of ≥0.78. A total of 80 nurses assessed task importance, difficulty, and frequency. Data were analyzed using descriptive statistics and the determinant coefficient. Results:The DACUM analysis identified a structured framework consisting of 10 duties and 39 tasks. "Emergency and crisis management" had the highest determinant coefficient, followed by "therapeutic milieu management," "psychosocial interventions," and "education and professional development." At the task level, crisis intervention and response, physical emergency nursing care, and management of safety incident recurrence were prioritized. Conclusion:DACUM-based job analysis clarified the structured roles of nurses in acute psychiatric intensive care units and highlighted job characteristics centered on emergency management and safety. These findings provide foundational data for standardizing nursing roles, establishing staffing strategies, and developing specialized clinical education programs for acute psychiatric care.
Purpose:This study focused on identifying key components and dimensions of positive patient experiences perceived by family members of nursing home residents in South Korea, which may inform strength-based quality improvement in nursing home care. Methods:Data were collected from May 8, 2023, to July 18, 2023, through interviews with 19 family members of nursing home residents aged 65 years or older who had lived in the facility for at least 30 days. Interview data were used to develop empirical statements on the nature of residents' experiences as perceived by family members. These data were then analyzed using concept mapping to identify components of positive patient experiences from the perspectives of family members of nursing home residents in Korea. Results:Multidimensional scaling and hierarchical cluster analysis yielded 59 core statements, two dimensions, and four clusters of positive patient experiences. The two dimensions were type of support (physical vs. emotional) and centrality of care (resident-centered vs. family-centered). The four clusters of positive patient experiences were "facility management focused on quality of life," "active communication and engagement," "respect and trust," and "professional and personalized care." Conclusion:These findings provide insight into the experiences valued by family members of older adults in nursing homes. The concept map may inform development of a patient experience index tailored to family members of nursing home residents.
Purpose:This study examined the effectiveness of a health literacy (HL) enhancement program in improving awareness of and preventive behaviors related to coronavirus disease 2019 (COVID-19) among older adults in an urban community in Bangkok, Thailand. Methods:This quasi-experimental study included 76 older adults in Dusit District, Bangkok. Eight participants were lost to follow-up; however, all 76 participants (38 per group) were included in the primary analysis using all available observations. The intervention was based on Pengjuntr's V-shape HL model, which includes six domains: access, understanding, interactive communication, decision-making, behavior change, and advocacy. The program was delivered through group sessions, LINE-based communication, community activities, and home visits. Data were collected at pre-test (baseline), post-test (4 weeks), and follow-up (12 weeks) using questionnaires. Outcomes were analyzed using linear mixed-effects models. This study was retrospectively registered with the Thai Clinical Trials Registry (TCTR20260502013). Results:At post-test, the experimental group had significantly higher COVID-19 awareness and preventive behavior scores than the control group (p<.001). Within-group analysis showed significant improvements in both COVID-19 awareness and preventive behavior at post-test and follow-up. Significant between-group differences were also observed at follow-up (p<.001), with higher scores in the experimental group. Conclusion:The intervention group receiving the HL enhancement program showed significant improvements in both COVID-19 awareness and preventive behaviors, which were sustained through follow-up. These findings support the use of nurse-led, community-based HL interventions with behavioral reinforcement to promote COVID-19 prevention among urban older adults.
Purpose:This study evaluated the effects of a hybrid simulation program using the metaverse and standardized patients to enhance delirium nursing competency among intensive care unit (ICU) nurses. Outcomes included delirium nursing knowledge, attitudes, and performance confidence. Methods:A quasi-experimental study with cluster allocation was conducted among 52 ICU nurses, including 28 in the experimental group and 24 in the control group. Data were collected from July 8 to August 28, 2024. The experimental group participated in a hybrid delirium nursing competency simulation program comprising two metaverse-based sessions (lectures, quizzes, discussions, and practice) followed by a face-to-face standardized patient simulation session. The control group received a conventional face-to-face lecture on delirium nursing. Data were analyzed using the chi-square test, the Fisher exact test, the independent t-test, and the paired t-test with IBM SPSS Statistics ver. 27.0. Results:After the intervention, the experimental group demonstrated significantly greater improvement in delirium nursing attitude (t=2.05, p=.046) and performance confidence (t=3.35, p=.002) compared with the control group. However, the change in delirium nursing knowledge did not differ significantly between groups (t=0.71, p=.483). Conclusion:The hybrid delirium nursing competency program using the metaverse and standardized patients was associated with greater positive changes in ICU nurses' delirium nursing attitudes and performance confidence than conventional lecture-based education. This immersive and interactive hybrid simulation approach may be a sustainable continuing education strategy for strengthening delirium nursing competency among ICU nurses.
Purpose:This study aimed to identify latent profiles of shift-work nurses according to perceived health, fatigue, and recovery levels and to examine differences across profiles in work-related outcomes, including sleep quality, work-life balance, job satisfaction, and turnover intention. It also examined whether patterns associated with participation in a shift-work improvement pilot project differed by latent profile. Methods:This descriptive cross-sectional study included 120 shift-work nurses working in pediatric wards at a tertiary hospital in South Korea. Data were collected from January 14 to 24, 2025. Latent profile analysis was performed using the 36-Item Short Form Health Survey and the Occupational Fatigue Exhaustion Recovery Scale. Differences in outcomes by latent profile membership and pilot-project participation status at the time of data collection were examined using two-way analysis of covariance, with age included as a covariate. Results:Three latent profiles were identified: Healthy-Recovery (20.8%), Moderate (41.7%), and Burnout-Vulnerable (37.5%). Significant differences among profiles were observed in sleep quality (F=37.37, p<.001), work-life balance (F=50.86, p<.001), job satisfaction (F=12.29, p<.001), and turnover intention (F=12.11, p<.001). A significant interaction between latent profile membership and pilot-project participation was observed for job satisfaction (F=4.77, p=.010, partial η²=.078). Pilot-project participation was associated with significantly higher job satisfaction only in the Healthy-Recovery profile (p=.005). Conclusion:Associations between pilot-project participation and work-related outcomes differed according to nurses' health, fatigue, and recovery profiles. These findings indicate that heterogeneity among shift-work nurses should be considered when interpreting work-related outcomes and designing tailored support strategies.
Purpose:This study aimed to develop and evaluate the Climate and Health Action Mitigation Program (CHAMP), a health education intervention designed to enhance middle school students' competencies for practicing climate adaptation behaviors in response to the health impacts of climate change. Methods:A quasi-experimental pretest-posttest nonequivalent control group design was employed. Data were collected from October to December 2024. A total of 3rd-year middle school students; 9th grade equivalent, aged 14-15 students were assigned to either an experimental group that received the CHAMP intervention or a control group that received conventional health education. The CHAMP curriculum comprised six sessions developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design model and was aligned with the 2022 revised national health curriculum and the instructional hours stipulated in the School Health Act. Climate adaptation competency and its seven subdomains-climate-change knowledge, climate sensitivity, reflective thinking, integrative thinking, communication skills, decision-making ability, and willingness to act-were assessed before and after the intervention. Results:Compared with the control group, the experimental group demonstrated statistically significant improvements (p<.01) in overall climate adaptation competency as well as in all seven subdomains. The largest improvements were observed in willingness to act, climate sensitivity, and climate-change knowledge. The CHAMP intervention was associated with meaningful improvements in students' climate adaptation competencies, encompassing cognitive, behavioral, and attitudinal domains. Conclusion:These findings support the feasibility and educational value of integrating climate-health content into the national curriculum. Future research should examine the scalability of CHAMP and evaluate its long-term sustainability and effects across diverse educational settings.
Purpose:This study aimed to develop and test a structural equation model of respiratory infection prevention behaviors among elementary school teachers based on the Information-Motivation-Behavioral Skills model. Methods:This study included 250 teachers who were currently working in elementary schools and had experience as homeroom teachers. Data were collected from December 18 to December 31, 2023 using self-reported questionnaires. The proposed model included school organizational culture as the exogenous variable and respiratory infection prevention knowledge, respiratory infection prevention attitude, social support, self-efficacy, and respiratory infection prevention behavior as endogenous variables. Data were analyzed using IBM SPSS for Windows ver. 24.0 and Smart PLS ver. 4.1. Results:Of the 19 hypothesized paths in the research model, five were statistically significant. School organizational culture had a significant direct effect on respiratory infection prevention knowledge (β=.20, p=.041), social support had a significant direct effect on self-efficacy (β=.33, p=.001), and self-efficacy had a significant direct effect on respiratory infection prevention behaviors (β=.22, p=.021). Respiratory infection prevention attitude (direct: β=.23, p=.029; total: β=.26, p=.008) and school organizational culture (direct: β=.22, p=.017; total: β=.30, p=.002) had significant direct and total effects on respiratory infection prevention behaviors. Conclusion:To enhance respiratory infection prevention behaviors among elementary school teachers, interventions should focus on strengthening positive attitudes toward infection prevention and improving self-efficacy. Organizational-level strategies, including establishing supportive school organizational cultures, promoting peer support among teachers, and sharing infection prevention practices within schools, are also needed to facilitate and sustain preventive behaviors.
Purpose:This study aimed to evaluate the effects of a practitioner-led empowerment program on self-sufficiency motivation, self-esteem, and self-efficacy among low-income service recipients at self-sufficiency centers. Methods:A quasi-experimental repeated-measures design was used. Participants were recipients of social services from 11 local self-sufficiency centers in Gyeonggi-do, South Korea. In total, 100 participants were recruited, with 51 assigned to the experimental group and 49 assigned to the control group. The experimental group received an eight-session program delivered by center practitioners who had been trained by mental health nurses, whereas the control group received usual services. Self-sufficiency motivation, self-esteem, and self-efficacy were assessed at three time points: baseline (pretest: T0), immediately after the intervention (post-test: T1), and 4 weeks after the intervention (follow-up: T2). Results:Using generalized estimating equations, participants in the experimental group showed significantly greater improvements than those in the control group at both T1 and T2 in self-sufficiency motivation (T1: B=1.61, p=.030; T2: B=2.88, p<.001), self-esteem (T1: B=2.77, p<.001; T2: B=2.78, p<.001), and self-efficacy (T1: B=3.95, p=.004; T2: B=4.19, p<.001). Conclusion:The practitioner-led program is associated with significant short-term improvements in psychosocial determinants of self-sufficiency among low-income service recipients. These findings may inform the development of community nursing interventions that support the psychosocial foundations of independent living in this population and provide a basis for training programs designed to strengthen the capacity of practitioners at local self-sufficiency centers (Clinical Research Information Service of Korea registration number: KCT0010027; registration date: December 12, 2024).
Purpose:This study analyzed public discourse on nurse retention through YouTube comments posted between 2018 and 2024 to examine how retention issues are collectively framed in online public spheres, thereby extending individual-level retention research to societal-level discourse analysis. Methods:Comments were collected from 226 YouTube videos uploaded between January 2015 and December 2024, identified using search terms that combined "nurse" with retention-related keywords. After duplicates and comments posted outside the study period were removed, 32,399 comments were analyzed using structural topic modeling with year and number of likes as covariates. Topic correlation network analysis with community detection was used to identify discourse coalitions. Results:Fourteen substantive topics and one noninterpretive topic emerged, spanning individual coping strategies, organizational workplace issues, and systemic policy structures. "International nursing migration and career pathways" (12.8%) and "Disputes regarding the scope of practice among professionals" (11.4%) were the most prevalent topics. Temporal analysis revealed discourse shifts consistent with focusing events theory: COVID-19 (coronavirus disease 2019) activated structural critique frames while suppressing career mobility discourse; the 2022 Nursing Law followed an issue-attention cycle pattern; and the 2024 medical school quota expansion embedded retention discourse within broader healthcare policy debates. Network analysis identified two discourse communities, professional identity and structural exploitation, with international migration serving as a bridging frame across both. Conclusion:Public discourse framed nurse retention as a systemic and structural issue rather than as an expression of individual professional rejection. These collective framing patterns complement traditional survey-based research and may inform policy design by identifying which frames achieve public resonance and where discourse fragmentation may challenge policy implementation.
Purpose:This study aimed to develop contextualized emergency nursing educational materials tailored to the Lao People's Democratic Republic (Lao PDR). Emergency nurses in Lao PDR face challenges arising from the lack of standardized, culturally relevant learning resources. Existing materials are often adopted from other countries and do not adequately reflect local needs, contributing to inconsistencies in clinical practice. Developing locally tailored resources, supported by official development assistance, is therefore essential for improving emergency nursing education and practice. Methods:This study used a methodological design based on the Four-Door Model-Define, Design, Develop, and Disseminate-from 2021 to 2024. A situational analysis was conducted using a mixed-methods approach that included a quantitative survey of 70 nursing professionals and qualitative interviews with 52 stakeholders. Content validity and suitability were evaluated by a panel of six local experts using standardized validation forms and the Suitability Assessment of Materials (SAM). Results:Ten emergency nursing domains were developed to address both universal principles, including triage protocols and life support interventions, and Lao PDR-specific challenges. Validity and suitability were supported by a SAM score of 77.3%, indicating clinical accuracy and cultural appropriateness. The 269-page coursebook was distributed to partner nursing colleges, three central hospitals, and international organizations. Conclusion:This study developed the first comprehensive emergency nursing educational materials tailored to the Lao PDR context and written in the local language. These materials support continuing professional development and license renewal every 5 years. They also exemplify an international development paradigm that prioritizes recipient-country ownership and sustainable capacity building through collaborative knowledge creation.
Purpose:This study aimed to examine the mediating effects of perceived organizational support and coping strategies on the relationship between job stress and professional quality of life among nurse managers working in tertiary and general hospitals. Methods:The participants were 299 nurse managers employed at tertiary and general hospitals located in Seoul and Gyeonggi Province. Data on job stress, perceived organizational support, coping strategies, and professional quality of life were collected using an online self-report questionnaire between June 28, 2024, and May 31, 2025. The collected data were analyzed using IBM SPSS Statistics ver. 27.0 and the PROCESS Macro ver. 4.0. Results:Job stress was identified as a significant predictor of professional quality of life among nurse managers. Perceived organizational support and active coping demonstrated significant mediating effects on compassion satisfaction. Active coping showed a significant mediating effect on burnout, whereas perceived organizational support mediated secondary traumatic stress. Passive coping did not demonstrate a significant mediating effect on any of the three subdomains of professional quality of life. Conclusion:Job stress is closely associated with compassion satisfaction, and this relationship is partially mediated by perceived organizational support and active coping. Accordingly, targeted interventions are required to reduce job stress, strengthen organizational support, and enhance coping competencies among nurse managers. Furthermore, reinforcing institutional- and policy-level support is essential to mitigate secondary traumatic stress and to ensure the sustainability of nurse managers' professional roles.
Purpose:This study aimed to examine nursing management competencies among nurses working in national specialized hospitals, to identify competency development needs and influencing factors, and to provide foundational data for the development of educational and competency-enhancement programs. Methods:A mixed-methods design was employed. Quantitative data were collected via an online survey of 162 nurses from five national specialized hospitals from January 10 to February 10, 2025, and qualitative data were obtained through in-depth interviews with 20 participants from March 7 to April 16, 2025. Quantitative data were analyzed using descriptive statistics, independent t-tests, analysis of variance, importance-performance analysis, the Borich Needs Assessment, the Locus for Focus model, and multiple regression analysis. Qualitative data were analyzed using content analysis with ATLAS.ti. Results:The mean performance score for nursing management competencies was 3.56±0.71 on a 5-point scale. Customer orientation received the highest score (4.03±0.78), whereas business and marketing received the lowest score (2.92±1.03). Across needs-assessment models, leadership, nursing ethics and law, quality improvement, and standard development consistently emerged as high-priority areas. In multiple regression analysis, the nursing work environment was the only factor significantly associated with nursing management competency performance (β=.33, p<.001). Qualitative content analysis corroborated these findings and identified three facilitator themes and three barrier themes. Conclusion:Nursing management competency performance among nurses in national specialized hospitals was associated with the nursing work environment, including organizational conditions. These findings underscore the importance of organizational support and suggest that competency-based education should be redesigned to prioritize high-need competency areas. This study provides a foundation for developing educational interventions and programs to enhance nursing management capacity.
Purpose:This study aimed to explore the lived experiences of clinical support nurses under the expanded scope-of-practice policy implemented after the mass resignation of medical residents in Korea in 2024. In Korea, these nurses are often referred to as physician assistant (PA) nurses, although they differ from licensed physician assistants or nurse practitioners in the United States. The study sought to understand how the policy was perceived, implemented, and interpreted by nurses who played a key role in maintaining clinical services during a healthcare workforce crisis. Methods:A qualitative phenomenological design based on Colaizzi's method was used. Fourteen clinical support nurses from a tertiary hospital in Seoul participated in in-depth, semi-structured interviews conducted between August and December 2025. The interviews were transcribed verbatim and analyzed through iterative reading, extraction of significant statements, formulation of meanings, and thematic integration. Trustworthiness was established using the criteria of credibility, dependability, transferability, and confirmability. Results:Four essential themes were identified: (1) multifaceted perceptions of the 98-item expanded scope-of-practice policy; (2) gaps in the current education system and demands for structured training; (3) ambivalent experiences during policy implementation; and (4) conditional acceptance of the policy's sustainability and calls for improvement. Participants reported increased professional recognition and autonomy while also experiencing ambiguity in role boundaries, concerns about legal accountability, and emotional burden related to insufficient preparation and protection. Conclusion:The expanded scope-of-practice policy both strengthens professional competence and creates role instability among clinical support nurses. Its sustainable implementation requires clear legal protection, standardized education and certification systems, appropriate compensation, and the active involvement of frontline nurses in policy development.
