Earticle

Purpose: This study analyzed the association between mental health factors and generalized anxiety disorder (GAD) in Korean adolescents by school classification (middle school, general high school, and specialized high school). Methods: The data from the 2024 Korea Youth Risk Behavior Survey were analyzed using multinomial logistic regression, adjusting for sociodemographic variables. Results: Perceived stress level, recovery from fatigue through sleep, sadness & hopelessness, suicidal thought, experience of loneliness significantly increased GAD risk in all school types (p<.001). Lifetime experience of habitual or intentional drug use showed a unique association with GAD in middle schools (OR=1.87, 95% CI=1.42~2.48). Conclusion: Tailored interventions are critical. Middle schools require transitional adaptation support and drug prevention programs, general high schools need academic stress management, and specialized high schools benefit from stigma reduction strategies. The study advocates for mandatory annual GAD screenings using a two-phase system (Mind EASY +GAD-7) and inter-ministerial collaboration to integrate school-based counseling with clinical services. Longitudinal research on COVID-19’s long-term mental health impacts and comorbid conditions (e.g., depression, ADHD) is recommended. These findings underscore the necessity of school-type-specific policies to address heterogeneous risk profiles and enhance early intervention efficacy.

Purpose: This study aimed to examine the levels of self-efficacy, career adaptation competency, and resilience in nursing students, and to analyze the relationships among these variables. Methods: A descriptive survey was conducted with 193 nursing students in Seoul from November to December 2024. Participants completed structured questionnaires measuring self-efficacy, career adaptation competency, and resilience. Correlation analysis and mediation analysis were performed to explore the relationships among variables and the mediating role of resilience. Results: Self-efficacy, career adaptation competency, and resilience were strongly correlated with each other (r=.66, p<.001). Resilience fully mediated the relationship between self-efficacy and career adaptation competency, with an explanatory power of 67% (p<.001). Career adaptation competency was significantly higher among students under 30, those with higher perceived economic status, excellent self-rated health, and the ones satisfied with their major and clinical practice. Additionally, self-efficacy and resilience showed a strong positive correlation. Conclusion: Resilience plays a significant mediating role between self-efficacy and career adaptation competency. Strengthening resilience is essential to enhance nursing students’ ability to adapt to their future careers.

Purpose: This study aimed to identify and compare factors related to generalized anxiety disorder (GAD) between multicultural and non-multicultural adolescents. Methods: The study utilized the secondary data from the 20th (2024) Korea Youth Risk Behavior Web-based Survey. A Rao-Scott chi-squared test and logistic regression analysis were conducted to analyze the differences and the factors associated with GAD among multicultural and non-multicultural adolescents. Adolescents were classified into the high-risk group of GAD based on a GAD-7 score of 10 or higher. Results: The mean GAD score was 11.36±4.68 for multicultural adolescents and 11.49 ±4.72 for non-multicultural adolescents. The proportion of adolescents classified as high-risk for GAD was 54.5% among multicultural adolescents and 55.8% among non-multicultural adolescents. Significant factors for high GAD risk in both groups were gender, perceived economic status, residential location, subjective health status, and perceived stress. However, academic performance, body image distortion, and body mass index were only significantly associated with GAD in non-multicultural adolescents. Conclusion: These findings suggest the need for targeted mental health interventions, including educational programs and psychosocial support systems, to prevent GAD in adolescents. Special attention should be given to sociocultural contexts when developing mental health strategies for multicultural youth.

Purpose: This study aimed to identify the effects of health-promoting behaviors, college student burnout, and loneliness on the learning flow of senior nursing students. Methods: A descriptive study design was adopted, and the data were collected through an online survey from 136 3rd-and-4th-year nursing students in three universities. The data were analyzed using independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis with SPSS 21.0 program. Results: Learning flow significantly differed depending on the satisfaction level of their major, and was significantly correlated with health-promoting behaviors, college student burnout, and loneliness. College student burnout and health-promoting behaviors significantly predicted senior nursing students’ learning flow, accounting for 30% of the variance. Conclusion: To improve learning flow of senior nursing students, interventions should focus on preventing burnout and enhancing health-promoting behaviors. Strategies may include coordinating the timing and workload of exams, assignments, and extracurricular activities, as well as increasing awareness of the importance of physical activity and encouraging its regular practice.

Purpose: This study aimed to evaluate the effectiveness of different educational methods used in the “Visit Early Childhood Infectious Disease Prevention Class” project by the Seoul Metropolitan Office of Education. Specifically, it compared a lecture-based method in 2023 with a participatory, play-based approach in 2024 that included home-based extension activities. Methods: A quasi-experimental, nonequivalent control group pretest-posttest design was applied. Participants included 108 children from 68 kindergartens in 2023 and 228 children from 184 kindergartens in 2024. Educational satisfaction was measured using structured questionnaires completed by kindergarten homeroom teachers and visiting health educators. Children’s accurate handwashing was assessed using a checklist, and immunity recognition was evaluated through individual interviews. In 2024, the program was enhanced with interactive methods such as games, songs, puzzles, handwashing experiments using fluorescent lotion, and home-based activities to support parent-child learning. The independent variable was the instructional method. Dependent variables were accurate handwashing, immunity recognition, and teacher satisfaction. The data were analyzed using t-tests, Mann-Whitney U tests, and Wilcoxon signed-rank tests. Results: The 2024 participatory program significantly improved children’s accurate handwashing and immunity recognition compared to the 2023 lecture-based group (p<.001). Teacher satisfaction also increased in 2024, with higher ratings on content relevance, student engagement, and instructional effectiveness. Conclusion: Play-based health education, combined with home-based activity, was more effective than traditional lecture methods in promoting hygiene behaviors and immunity awareness in preschool children. Visit health education led by experienced retired school nurses may serve as an effective strategy for kindergartens without assigning health professionals.

Purpose: This study aimed to develop a home-linked program to prevent smoking harm to three-year-old children and to verify its effectiveness in enhancing the smoking harm prevention competencies of both young children and their caregivers. Methods: The participants were 89 three-year-old children enrolled in eight early childhood education institutions in Seoul, Gyeonggi, and Chungnam regions, along with their 65 caregivers. The program consisted of four stages: "Pre-learning," "Storytelling and Discussion," "Family Play Activities," and "Activity Expansion," supported by news cards and video resources to facilitate home-based implementation. The data were analyzed using SPSS/WIN 21.0, applying reliability analysis (Cronbach’s ⍺), descriptive statistics (means and standard deviations), and paired t-tests. Results: The results showed statistically significant improvements in children's smoking harm prevention competencies (knowledge, skills, and attitudes) and caregivers' competencies (knowledge, attitudes, and practices) after the program participation. In particular, a notable enhancement was observed in caregivers' practice domain, indicating that the program effectively promoted actual behavioral change. This study provides the foundational data supporting the importance of home-based approaches and the development of age-appropriate educational programs in early childhood health education. Conclusion: The program enhanced smoking harm prevention competencies in children and promoted practical health behaviors of caregivers, indicating its effectiveness beyond merely imparting information.

Purpose: This study aimed to develop and evaluate the effectiveness of a school-based obesity prevention program for elementary school students, based on the ecological model. Methods: A non-equivalent control group pretest-posttest design was employed. Participants were 85 fourth-grade students from two elementary schools in U Metropolitan City, with one class from each school assigned to the intervention group (n=42) or the experimental group (n=43). The intervention group participated in the Be Healthy, Not Just Fit program, conducted 40 minutes weekly for eight weeks. The program addressed five ecological levels; individual, interpersonal, organizational, community, and policy, through both educational and experiential activities. The data were collected on anthropometric indicators (height, weight, and body mass index) and validated questionnaires measuring dietary and exercise behaviors, obesity-related knowledge, self-esteem, self-efficacy, and perceived social support. Statistical analyses included paired t-tests and ANCOVA, with significance set at p<.05. Results: The intervention group demonstrated statistically significant improvements in height (p<.001), weight (p<.001), dietary behaviors (p=.021), exercise behaviors (p=.049), obesity-related knowledge (p<.001), self-esteem (p=.006), and selfefficacy (p=.001). Although BMI and perceived social support increased, these changes did not reach statistical significance. Two-group-comparisons indicated greater gains in the intervention group for exercise behaviors (p=.039), obesity-related knowledge (p=.012), and self-efficacy (p=.038). Conclusion: A multilevel, school-based intervention grounded in the ecological model positively influenced health-related behaviors and psychological outcomes in elementary school children. These findings highlight the importance of integrated strategies that put together schools, families, and communities to promote healthy lifestyles and prevent childhood obesity.

Purpose: This study aimed to examine the impact of bicultural experience on risk factors for school dropout among multicultural adolescents and to explore the mediating effect of social support for this group of students. Methods: The study utilized the data from the 5th year of the 2nd phase of the Multicultural Adolescents Panel Study (MAPS: 2019~2023) and included 1,800 participants who were selected as part of the study sample. To identify the mediating effect, general characteristics that showed significant differences were treated as covariates and analyzed using the SPSS PROCESS Macro. Results: First, the risk factors for school dropout showed a statistically significant negative correlation with bicultural experience and social support, whereas bicultural experience and social support showed a statistically significant positive correlation. Second, bicultural experience did not show a significant direct effect on the risk factors for school dropout (B=-0.02, 95% CI=-0.05, 0.01), however, social support showed a significant indirect effect (B=-0.04, 95% CI=-0.06, -0.03). Bicultural experience was found to indirectly affect risk factors for school dropout through social support. Conclusion: In order to prevent risk factors for school dropout among multicultural adolescents, it is necessary to develop and apply strategies to have positive bicultural experience and strengthen social support.